UC-NRLF 


.1915 


OF  THE 

UNIVERSITY 

OF 


THE  MUNICIPAL  CONTROL  of 
TUBERCULOSIS    IN  CHICAGO 


City  of  Chicago 

Municipal  Tuberculosis 

Sanitarium 


D    D    D 


ITS  HISTORY 
and  PROVISIONS 


CHICAGO 
1915 


City  of  Chicago 

Municipal  Tuberculosis 

Sanitarium 

D    D    D 

BOARD  OF  DIRECTORS 

THEODORE  B.  SACHS,  M.  D.  President 

GEORGE  B.  YOUNG,  M.  D.  -    Secretary 

W.  A.  WIEBOLDT 

D     D    D 

FORMER  MEMBERS  OF  BOARD 

HARLOW  N.  HIGINBOTHAM  WM.  A.  EVANS,  M.  D. 

ODD 

GENERAL  OFFICE 

105  West  Monroe  Street 
Telephone  Central  8644 

FRANK  E.  WING  -      Administrative  Secretary 

ODD 

SANITARIUM 

North  Crawford  and  Bryn  Mawr  Avenues 
Telephone  Monticello  3500 

J«  W.  COON,  M.  D.    -     Superintendent  and  Medical  Director 


W.  A.  GEKLBR,  M.  D.  HARRY  J.  CORPER.  M.  D. 

Associate  Medical  Director  Laboratory  Director 

CORNELIA  L.  ALLEN,  R.  N.  A.  A.  BACHLER 

Superintendent  of  Nurses  Business  Agent 


THE  MUNICIPAL  CONTROL  of 
TUBERCULOSIS   IN   CHICAGO 


City  of  Chicago 

Municipal  Tuberculosis 

Sanitarium 


D    D    D 


ITS   HISTORY 
and  PROVISIONS 


D  n  n 


To  the  Mayor 

and  the  City  Council  of  the 

City  of  Chicago 


ODD 


CHICAGO 

1915 


cy 


DEDICATED 

to  the  Tuberculosis  Workers  of  Chi- 
cago, whose  devotion  to  the  cause 
and  whose  unqualified  support  were 
a  source  of  strength  in  the  gradual 
realization  of  plans  for  efficient  con- 
trol of  tuberculosis  in  this  com- 
munity. 

THEODORE  B.  SACHS,  M.  D. 
Chicago,  February  16,  1915. 


M54G14O 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


CONTENTS 

Page 

THE  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM. 
ITS  HISTORY  AND  PROVISIONS.  By  Theodore  B.  Sachs,  M.  D., 
President  Board  of  Directors  Municipal  Tuberculosis  Sanitarium ...  9  to  68 

CHAPTERS— 

Introduction    7 

The  City  Tuberculosis  Sanitarium  Act  of  Illinois:  History  of  the  Act — 
Adoption  of  the  City  Tuberculosis  Sanitarium  Act — The  City  Tuberculosis 
Act  of  Illinois  Developed  Through  Amendments  of  the  Original  Sanitarium 
Act:  Its  Main  Provisions — The  First  Board  of  Directors — Preliminary 
Steps  in  Planning  the  Sanitarium — The  Organization  of  a  System  of  Tu- 
berculosis Dispensaries — Purchase  of  the  Sanitarium  Site — Preparation  of 
Plans. 

Description  of  the  Sanitarium 20 

The  Grounds — Layout  of  Buildings — Provisions  of  the  Chicago  Municipal 
Tuberculosis  Sanitarium. 

Some  Important  Features  of  the  Organization  of  the  Chicago  Munici- 
pal Tuberculosis  Sanitarium — A  Municipal  Organization  of  a  Sanitarium, 
Dispensaries  and  Other  Auxiliary  Agencies  Essential  in  Control  of  the 
Disease 25 

The   Dispensary  Department ,. ,     25 

Bureau  of  Special  Relief 32 

Education  by  Literature  and  Exhibits 34 

Important  Features  of  the   Sanitarium  Proper 37 

Provision  for  Incipient  and  Moderately  Advanced  Cases — Comprehensive 
Medical  and  Laboratory  Facilities  for  the  Study  and  Treatment  of  Cases 
— Separate  Grounds  for  Male  and  Female  Patients — The  Plan  of  Medical 
Supervision  of  Cases — Laboratory  Study  of  Cases — Post-Mortem  Study  of 
Cases — X-Ray  Study  of  Cases — Study  and  Treatment  of  Nose  and  Throat 
Conditions — Dental  Conditions — Orthopedic  Department — Surgical  De- 
partment— Provision  for  Tuberculous  Children — Maternity  Department  for 
Tuberculous  Women — Nursery  for  Infants  of  Tuberculous  Parents — Pro- 
visions for  Isolation  of  Suspicious  Cases  of  Contagious  Disease — Open  Air 
Quarters  for  Ex-patients. 

Description  of  Individual  Buildings 43 

Administration  Building  43 

Service   Building 45 

Patients'  Dining  Halls  48 

Infirmary   Group 49 

Quarters  and  Grounds  for  Ambulant  Cases 53 

Cottages  for  Adults 55 

Cottages  for  Children 58 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


CONTENTS— Cont'd 

Page 

Unit  Administration   Buildings    60 

Nurses'   Home 61 

Power  House  and  Laundry 63 

Transformer   Station    66 

Farm  Buildings   66 

Gate  Lodge — Fence — Tunnel    66 

Acknowledgments   67 

Conclusion    68 

ADDENDA 
Dedication  Exercises 

Invocation,  the  Very  Rev.  Peter  J.  O'Callaghan,  C.  S.  P 69 

Introductory   Address — Theodore    B.    Sachs,    M.    D.,    President    Board    of 

Directors    69 

Response — George  B.  Young,   M.  D.,   Commissioner  of  Health  and  Sec- 
retary, Board  of  Directors 72 

Address — W.  A.  Wieboldt,  Member  Board  of  Directors 73 

Address — State   Senator   Edward   J.    Glackin 74 

The  Illinois  City  and  Village  Tuberculosis  Law 77 

Classified  Statement  of  Yearly  Expenditures 82 

Sanitarium  Receipts  and  Expenditures  by  Years 84 

Statistics  of  Mortality  from  Tuberculosis  in  Chicago 86 

Statistics  of  Municipal  Registration  of  Tuberculosis  in  Chicago 87 

Examinations  of  Sputum  by  the  Bacteriologist  of  the  Dispensary  Depart- 
ment of  the  Sanitarium  87 

Charts — Dispensary  Statistics    88 

Directory  of  Tuberculosis  Institutions  in  Chicago  and  Cook  County 90 

Directory  of  Tuberculosis  Organizations  in  Chicago 91 

Staff  of  Dispensary  Department  92 

Index   .  93 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


LIST  OF  ILLUSTRATIONS 


Page 

Frontispiece — Bird's  Eye  View  of  the  Chicago  Municipal  Tuberculosis  Sani- 
tarium         8 

"Mr.  Voter,"  Poster  Used  in  Chicago  Campaign  for  the  Municipal  Tuber- 
culosis Sanitarium 11 

Layout  of  the  Sanitarium  Buildings  and  Grounds 21 

Map  Showing  Location  of  the  Ten  Free  Dispensaries  of  the  Chicago  Mu- 
nicipal Tuberculosis  Sanitarium 24 

Waiting  Room — Stock  Yards  Tuberculosis  Dispensary 26 

Floor  Plan — Stock  Yards  Tuberculosis  Dispensary 27 

Proposed  Central  South  Side  Municipal  Tuberculosis  Dispensary 28 

Floor  Plans — Proposed  Central  South  Side  Dispensary 29 

Interior  Views  of  Some  of  the  Free  Tuberculosis  Dispensaries 30 

Floor  Plan  of  the  Municipal  Tuberculosis  Clinic  in  the  Emanuel  Mandel 
Memorial  Dispensary  of  the  Jewish  Aid  Society,  Corner  Maxwell  and 

Miller  Streets 32 

Examples  of  Work  Done  by  the  Bureau  of  Special  Relief  of  the  Dispensary 

Department    33 

View  of  Section  of  the  Chicago  Tuberculosis  Exhibit 35 

One  of  the  Large  Audiences  in  Attendance  at  the  Conferences  Conducted 

in  Connection  With  the  Chicago  Tuberculosis  Exhibit 36 

Organization  Diagram 37 

Men's  Grounds  and  Women's  Grounds 39 

Administration  Building 43 

Floor  Plans  of  Administration  Building 44 

Men's  Dining  Hall,  Service  Building  and  Women's  Dining  Hall 46 

Floor  Plans  of  Service  Building  and  Dining  Halls 47 

Infirmary,  First  Floor  Plan 51 

Infirmary,  Second  Floor  Plan 52 

Basement  Plan,  Infirmary  Administration  Building  and  Part  of  Infirmary 

Wings    53 

Infirmary    Group 54 

Group  of  Adult  Patients'  Cottages 54 

Type  of  Adult  Patients'  Cottages 56 

Floor  Plan  of  Adult  Patients'  Cottage 57 

Type  of  Children's  Cottage 58 

Floor  Plan  of  Children's  Cottage 59 

Unit  Administration  Building 60 

Floor  Plan  of  Unit  Administration  Building 61 

Floor  Plan  of  Nurses'  Home 62 

Nurses'    Home 63 

First  Floor  Plan — Power  House  and  Laundry 64 

Power   House 65 

Charts — Dispensary    Statistics 88  and  89 


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The 

Chicago  Municipal  Tuberculosis  Sanita 
rium.     Its  History  and  Provisions 

By  Theodore  B.  Sachs,  M.  D.,  President,  Board  of  Directors 
Chicago  Municipal  Tuberculosis  Sanitarium 


The  first  recognition  of  necessity  of  institutional 

The  City  Tubercu-  provision  for  the  treatment  of  tuberculosis  in 
losis  Sanitarium  Act  the  State  of  Illinois,  which  found  expression  in 
of  Illinois.  History  a  State  Legislative  Act  creating  such  a  provision, 
of  the  Act  was  on  February  23,  1905,  when  Senator  Edward 

J.  Glackin  of  Chicago  introduced  in  the  Forty- 
Fourth  General  Assembly,  "AN  ACT  for  the  establishment  of  a  State 
Sanitarium  for  the  care  of  curable  cases  of  tuberculosis"  (House  Bill 
No.  136),  calling  for  an  appropriation  of  200,000  dollars  for  the  pur- 
chase of  land  and  the  construction  of  buildings.  With  subsequent 
amendments  and  with  the  appropriation  reduced  to  25,000  dollars,  the 
bill  passed  both  branches  of  the  legislature  in  May,  1905,  but  failed  to 
receive  the  approval  of  the  Governor.  Since  then  four  bills  (in  1907, 
1909,  1911  and  1913)  for  the  establishment  of  a  State  Tuberculosis  Sani- 
tarium were  introduced  in  the  legislature  by  Mr.  Glackin,  but  failed  to 
receive  the  necessary  support. 

During  the  intervening  period,  the  judgment  of  men,  who  have  made 
a  study  of  the  tuberculosis  situation  in  this  State,  has  been  gradually 
crystallizing  in  favor  of  legislation  enabling  cities  and  counties  to  con- 
struct and  operate  sanitaria  for  the  care  of  their  own  tuberculous  patients. 
This  judgment,  in  favor  of  city  and  county,  as  against  state  sanitaria  pri- 
marily found  expression  in  "AN  ACT  to  enable  cities  and  villages  to 
establish  and  maintain  public  tuberculosis  sanitariums,"  introduced  by 
Mr.  Glackin  as  Senate  Bill  No.  598  on  January  14,  1908.  The  bill  pro- 
vided for  a  special  municipal  four  mill  sanitarium  tax  for  the  construction 
and  maintenance  of  a  sanitarium,  in  any  city  or  village  which  adopts  the 
provisions  of  the  law  by  a  majority  referendum  vote  at  a  municipal 
election.  The  bill  was  enacted  into  law,  approved  by  the  Governor,  and 
became  effective  on  July  1,  1908. 


10  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

Chicago,  with  its  large  tuberculosis  problem,  was 

Adoption  of  the  City  naturally  the  first  city  in  the  State  to  study  this 
Tuberculosis  Sanita-  law  in  its  application  to  the  local  situation.  The 
rium  Act  (as  Sub-  Chicago  Tuberculosis  Institute  (an  organization 
sequently  Amended)  of  physicians  and  laymen,  chartered  March  17, 
by  Chicago  and  1906,  having  for  its  purpose  "the  prevention  and 

Other  Cities  of  Illi-  treatment  of  consumption  and  other  forms  of 
nois  tuberculosis")  gave  this  important  measure  thor- 

ough consideration  and  resolved  to  advocate  its 

acceptance  by  the  municipality  provided  certain  amendments  were  en- 
acted, the  chief  of  which  was  the  reduction  of  the  maximum  rate  of  tax 
levy  from  four  mills  to  one.  This  was  accomplished  during  the  regular 
biennial  session  of  the  Forty-Sixth  General  Assembly  through  an  amend- 
ment passed  on  March  12,  1909,  and  immediately  after  that  the  Institute 
proceeded  with  a  campaign  for  the  adoption  of  the  Sanitarium  Act  by 
the  voters  of  Chicago. 

The  campaign  conducted  by  the  Institute  for  the  adoption  of  the 
Act  was  remarkable  in  a  number  of  respects : 

First.  The  amendment  passed  both  branches  of  the  Legislature 
on  March  10,  1909,  and  was  signed  by  the  Governor  on  March  llth.  The 
last  day  to  file  petitions  for  submission  of  any  question  to  a  referendum 
vote  at  the  coming  election  in  Chicago  was  March  12th.  No  difficulty 
was  encountered,  however,  in  obtaining  1,000  signatures  in  the  short 
period  of  twenty-four  hours. 

Second.  The  campaign  for  the  adoption  of  the  Sanitarium  Act 
by  the  voters  was  used  as  an  opportunity  to  spread  education  on  the 
subject  of  tuberculosis,  its  method  of  cure  and  prevention.  It  was 
an  aldermanic  election  and  "Tuberculosis"  talks  and  appeals  for  the 
adoption  of  the  Act  were  made  a  feature  of  ward  meetings  of  all 
political  parties  in  every  section  of  the  City.  The  Directors  of  the 
Institute,  physicians,  nurses,  clergymen,  social  workers,  men  and 
women  of  various  professions  and  trades  gave  enthusiastic  aid  and 
with  the  unqualified  endorsement  of  all  Chicago  newspapers,  leading 
social  organizations,  labor  unions,  etc.,  the  measure  won  by  a  ma- 
jority of  127,820  votes,  the  vote  being  167,230  "For"  and  39,410 
"Against"  the  proposition. 

Third.  Of  the  254,025  ballots  cast  at  that  aldermanic  election, 
206,640  (81%  of  the  total)  were  recorded  for  or  against  the  measure. 

The  heavy  vote  cast  on  this  referendum  proposition,  as  well  as  the 
overwhelming  majority  of  votes  recorded  in  its  favor,  emphatically  dem- 
onstrated the  effectiveness  of  the  campaign  of  education  carried  on  by 
the  Chicago  Tuberculosis  Institute  in  the  preceding  three  years. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


MR.  VOTER! 

3500  FELLOW  CHICACOANS 
WERE  KILLED  LAST  YEAR  BY 

The  Great Jfhite  Piape 

CES  OF  TH 
!E  LIKE  THI 

m 


3500  MORE  ARE  IN  THE  EARLY  STAGES  OF  THE 
DISEASE  AND  CAN  BE  CURED  BY  CARE  LIKE  THIS 

- ,,.  -^~,        __— — -       •      JM 


M 


HHBHL  TUBEBGUlfelS  SftNftTMIUM  m  THE  aumir 


"We  must  care  for  the  CONSUMPTIVE  at  the  right  time,  i« 
the  Hgtrt  place,  and  in  the  right  way,  UMTIL  HE  IS  CURED; 
instead  of,  as  now,  at  the  wrong  time,  in  the  wrong  place, 
and  in  the  wrong  way,  UNTIL  HE  IS  DEAD." 

IT  IS  UP  TO  YOU! 


Since  1909  the  Act  has 
been  adopted  by  other  cities  in 
Illinois  (Rock  Island,  Peoria, 
Rockford  and  Belleville),  the 
actual  construction  of  sanitaria 
in  said  cities  having  been  de- 
layed temporarily  by  obstacles 
incident  to  launching  of  tuber- 
culosis institutions  in  new  local- 
ities. In  all  these  cities  large 
majorities  were  recorded  in  the 
referendum  vote  on  the  adop- 
tion of  the  Act. 

In  Rockford  the  construc- 
tion of  the  sanitarium  is  in 
progress.  A  site  has  been  pur- 
chased in  Rock  Island  and  plans 
are  being  prepared. 


The  City  Tubercu- 
losis Act  of  Illinois 
Developed  Through 
Amendments  of 
the  Original  Sanita- 
rium Act.    Its  Main 
Provisions 


The  first  step  toward  the  organization  and  opera- 
tion of  the  Municipal  Tuberculosis  Sanitarium  of 
Chicago  was  made  possible  by  anticipation  in 
September,  1910,  of  a  fraction  of  the  1910  tuber- 
culosis tax  levy.  Since  then  the  various  activities 
of  the  Sanitarium  have  been  developing  under 
the  provisions  of  the  original  City  Tuberculosis 
Sanitarium  Act  as  amended  on  March  12,  1909. 
The  construction  of  the  Sanitarium  proper 

began  November  27,  1911,  and  antedating  this  by  a  year  and  two  months 
(September  1,  1910)  the  Municipal  Tuberculosis  Dispensary  system  was 
created  under  a  liberal  interpretation  of  the  original  law. 

With  the  gradual  development,  however,  of  the  various  activities 
necessitated  by  the  existing  tuberculosis  situation  in  Chicago,  it  became 
apparent  that  the  solution  of  the  problem  demanded  the  introduction  and 
operation  of  additional  agencies  besides  the  sanitarium  and  its  dis- 
pensaries and  that  the  original  Tuberculosis  Sanitarium  Act  should  be  so 
amended  as  to  transform  it  into  a  comprehensive  City  Tuberculosis  Act 
permitting  the  operation  of  all  tried  agencies  and  methods  for  the  gradual 
reduction  of  tuberculosis  prevalence  in  the  city. 


12  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

This  was  accomplished  through  the  introduction  by  Senator  Glackin 
in  the  Forty-Eighth  General  Assembly,  on  June  27,  1913,  of  an  amend- 
ment (Senate  Bill  No.  515)  which  widely  broadened  the  powers  of  the 
Municipal  Tuberculosis  Sanitarium. 

As  the  Illinois  City  Tuberculosis  Act  reads  at  present,  it  contains 
the  following  important  provisions: 

(1)  The   Act   becomes    operative    in    any   municipality   following   a 
favorable  referendum  vote  at  any  general  election.     The  submission  of 
the  Act  to  a  referendum  vote  requires   a  petition  signed  by   100  legal 
voters. 

(2)  The. Act  confers  on  municipalities  the  power  to  "establish  and 
maintain  a  public  sanitarium  and  branches,  dispensaries,  and  other  auxil- 
iary institutions  .  .  .  for  the  treatment  and  care  of  persons  afflicted  with 
tuberculosis"  and  "to  extend  the  benefits  and  privileges  of  such  institu- 
tion, .  .  .  into  the  homes  of  persons  afflicted  with  tuberculosis,  and  to 
furnish  nurses,  instruction,  medicines,  attendance  and  all  other  aid  neces- 
sary to  effect  a  cure,  and  to  do  all  things  in  and  about  the  treatment 
and  care  of  persons  so  afflicted  which  will  have  a  tendency  to  effect  a 
cure  of  the  person  or  persons  afflicted  therewith  and  to  stamp  out  tuber- 
culosis in  such  city." 

(3)  A  special  "Tuberculosis  Sanitarium  Fund"  is  created  for  this 
purpose,  its  source  being  "a  tax  not  to  exceed  one  mill  on  the  dollar 
annually  on  all  taxable  property  of  such  city."     This  tax  is  free  from 
any  limitations  to  which  some  taxes  are  subject  in  this  State. 

(4)  The    administrative    direction    of    the    Sanitarium    and    all    its 
branches  is  vested  in  a  board  of  three  directors,  appointed  for  three-year 
terms  by  the  mayor,  with  the  approval  of  the  city  council. 

(5)  Treatment  in  the  Sanitarium  and  its  branches  is  free  to  all  resi- 
dents afflicted  with  tuberculosis.    In  case  of  non-residents,  the  conditions 
of  admission  are  determined  by  the  Board  of  Directors. 

The  law  contains  one  limitation  that  was  unexpectedly  inserted  into 
its  provisions  during  the  closing  hours  of  the  Forty-Eighth  General 
Assembly,  namely :  "Provided  that  no  person  so  afflicted  be  compelled  to 
enter  such  sanitarium  or  any  of  its  branches."  While  it  is  our  judgment 
that  the  general  efficiency  of  sanitaria  and  other  auxiliary  agencies  for  the 
control  of  tuberculosis  should  be  mainly  relied  upon  in  drawing  to  such 
institutions  the  tubercular  sufferer,  and  that,  after  all  education  of  the 
community  is  the  most  potent  factor  in  the  control  of  any  communicable 
disease,  the  last  clause,  nevertheless,  takes  away  from  an  otherwise  com- 
prehensive arrangement  the  means  of  controlling  that  small  percentage 
of  tuberculous  sufferers  who  persistently  refuse  to  take  all  the  necessary 
precautions  against  the  spread  of  infection. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  13 

Except  for  the  above  limitation  which  sooner  or  later,  no  doubt,  will 
be  eliminated  from  the  law,  the  Illinois  City  Tuberculosis  Act  stands  out 
as  a  model  Act  for  the  control  of  tuberculosis  in  a  municipality. 

For  the  present,  forcible  removal,  if  unavoidable  in  certain  excep- 
tional cases,  can  be  accomplished  through  the  police  power  of  Municipal 
Departments  of  Health. 

The  City  Tuberculosis  Sanitarium  Act  of  Illinois, 

The  County  Tuber-  adopted  by  Chicago  in  April,  1909,  and  subse- 
culosis  Sanitarium  quently  by  other  cities,  was  intended  chiefly  to 
Act  of  Illinois  meet  the  needs  of  the  large  centers  of  population 

in  this  State. 

To  meet  the  requirements  of  small  municipalities  and  rural  com- 
munities, the  General  Assembly  enacted  on  April  26,  1909,  an  amend- 
ment to  the  County  Law  of  1874  (House  Bill  No.  165,  passed  by  the 
Forty-Sixth  General  Assembly)  enabling  counties  in  the  State  to  erect 
and  maintain  county  tuberculosis  sanitariums.  Under  the  provisions  of 
this  law,  Cook  County  erected  a  modern  tuberculosis  hospital  of  600  bed 
capacity  at  Oak  Forest,  and  a  campaign  for  a  more  widespread  applica- 
tion of  the  law  is  being  carried  on  in  the  State  by  the  Illinois  State  Asso- 
ciation for  the  Prevention  of  Tuberculosis,  with  the  prospect  of  several 
county  tuberculosis  institutions  coming  into  existence  within  the  next  few 
years. 

To  further  strengthen  the  position  of  the  counties  in  their  fight 
against  tuberculosis,  the  law  dealing  with  the  institutional  provision  for 
the  treatment  of  tuberculosis  in  counties  should  be  amended  and  broad- 
ened in  the  following  way : 


First.  The  County  Tuberculosis  Act  should  be  freed  from  all  con- 
nection with  the  "County  Poor"  law. 

Second.  The  provisions  of  the  Act  should  include  not  only  sanitaria, 
but  all  other  auxiliary  agencies  necessary  for  the  control  of  the  disease  in 
the  county,  as  dispensaries,  day  camps,  etc. 

Third.  The  Act  should  permit  counties  to  use  all  well  tried,  efficient 
methods  "for  stamping  out  tuberculosis,"  as  education  by  means  of  ex- 
hibits, literature,  etc. 

Fourth.  Inclusion  of  a  clause,  permitting  construction  and  operation 
of  a  sanitarium  and  other  auxiliary  agencies  by  a  combination  of  several 
adjoining  counties. 

The  County  Tuberculosis  Act  should  be  made  as  comprehensive  in 
its  provisions  as  the  present  City  Tuberculosis  Act. 


14  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

The  City  Tuberculosis  Act  as  originally  framed, 

The  First  Board  of  became  operative  in  Chicago  on  April  6,  1909. 
Directors  of  the  On  April  19,  Mayor  Busse  appointed,  with  the 

Municipal  Tubercu-  approval  of  the  Council,  a  Board  of  Directors 
losis  Sanitarium:  to  administer  the  "Tuberculosis  Sanitarium 

Preliminary  Steps  in  Fund"  accruing  under  the  operation  of  the  spe- 
Planning  the  Sani-  cial  municipal  tax  levied  for  that  purpose,  as 
tarium  well  as  to  prepare  plans  of  the  Sanitarium  for 

which  the  "Fund"  was  originally  created. 

The  first  Board  of  Directors  of  the  Sanitarium  consisted  of  Mr. 
Harlow  N.  Higinbotham,  Dr.  Theodore  B.  Sachs,  and  Dr.  William  A. 
Evans,  Commissioner  of  Health,  ex-officio.  The  Board  organized  on 
April  22,  1909,  with  Mr.  Harlow  N.  Higinbotham  as  President  and  Dr. 
Theodore  B.  Sachs  as  Secretary. 

As  the  funds  for  building  the  Sanitarium  could  not  be  made  available 
until  January,  1911,  because  of  certain  provisions  in  the  special  sanitarium 
and  general  tax  law  which  had  to  be  first  complied  with,  the  Board  of 
Directors  devoted  themselves  during  the  intervening  period  to  the  investi- 
gation of  the  tuberculosis  situation  and  its  needs  in  Chicago,  as  well  as 
to  the  study  of  municipal  provisions  for  the  control  of  the  disease  in  other 
large  cities  of  this  country. 

The  actual  work  of  directing  and  mapping  out  the  plans  of  the 
Sanitarium  was  assigned  on  March  1,  1911,  to  Dr.  Theodore  B.  Sachs, 
at  that  time,  Secretary  of  the  Board. 

From  the  outset  the  Board  was  united  in  the 

The  Organization  of  purpose  of  so  utilizing  the  various  provisions  of 
a  System  of  Tuber-  the  original  Sanitarium  Law  as  to  render  possi- 
culosis  Dispensaries  ble  a  gradual  assumption  of  control  of  the  exist- 
ing tuberculosis  situation.  In  its  literal  interpre- 
tation, the  original  law  provided  for  the  building  of  a  Sanitarium  and 
its  text  did  not  contain  any  specific  reference  to  dispensaries  and  other 
auxiliary  agencies  without  which  municipal  control  of  tuberculosis  is 
impossible.  The  general  intent  of  the  law,  however,  was  broader  than 
its  literal  interpretation  and  on  November  15,  1909,  the  Board  of  Direc- 
tors received  from  the  Corporation  Counsel  an  opinion  holding  that  dis- 
pensaries, as  "stations  or  outposts  of  the  Sanitarium,"  are  essential  to 
the  detection  of  cases  of  tuberculosis  in  a  stage  in  which  the  sanitarium 
treatment  would  be  most  efficient  and  hence  dispensaries  may  be  consid- 
ered an  integral  part  of  the  Sanitarium. 

With  this  interpretation  of  the  law,  the  Municipal  Tuberculosis  Sani- 
tarium anticipated  the  tax  levy  of  1911  by  issuing  tax  warrants  to  the 
amount  of  $10,000,  and,  on  September  1,  1910,  entered  into  an  agree- 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  15 

ment  with  the  Chicago  Tuberculosis  Institute  by  which  the  seven  dis- 
pensaries operated  by  the  Institute,  passed  under  the  control  of  the  Sani- 
tarium. 

With  the  transfer  of  the  dispensaries,  their  nursing  staff,  consisting 
of  Superintendent  of  Nurses,  Miss  Edna  L.  Foley,  and  eleven  Field 
Nurses  were  retained  in  their  respective  positions  by  the  Sanitarium.  Mr. 
Frank  E.  Wing,  at  that  time  Superintendent  of  the  Institute,  was  elected 
by  the  Board  of  Directors  of  the  Sanitarium,  as  General  Superintendent. 
Thus  a  foundation  was  laid  of  a  comprehensive  Municipal  Tubercu- 
losis Dispensary  System,  around  which  it  was  planned  to  group  all  other 
institutional  agencies  for  the  control  of  tuberculosis  in  Chicago. 

The  history  of  acquiring  a  site  for  the  Municipal 

The  Purchase  of  Tuberculosis    Sanitarium   of   Chicago   covers    a 

the  Sanitarium  Site       persistent  eight  months'  campaign   (July,   1910, 

to  January,  1911)  to  overcome  the  unwarranted 

prejudices  of  various  classes  in  the  community  against  the  location  of  a 
tuberculosis  institution  in  their  midst.  The  original  law  definitely  pre- 
scribed the  location  of  the  Sanitarium  within  the  limits  of  the  City.  This 
clause  did  not  conform  to  the  practice  of  other  large  cities  of  this  country 
in  establishing  sanitaria  in  country  locations,  more  or  less  distant  from 
city  limits.  Nevertheless,  after  considerable  study  of  the  situation  the 
conclusion  was  reached  by  the  Board,  that  a  sanitarium  located  within 
the  city  limits  would  be  productive  of  an  immeasurable  amount  of  good 
to  the  community  and  this,  for  the  following  reasons : 

1.  Greater  facility  of  control  of  an  institution  subject  exclusively 
to  the  ordinances  of  the  city  and  unhampered  by  the  prejudices  of  other 
communities. 

2.  Accessibility  of  the  institution  to  friends  and  relatives  of  patients, 
permitting  the  continuance  of  that  important  link  between  the  patient 
and  his  family  which  is  of  utmost  importance  in  keeping  patients  in  sani- 
taria for  long  periods  of  time. 

3.  Accessibility   of   the   institution   to   the   entire   community,   the 
Sanitarium  standing  within  its  confines  as  an  exposition  of  "right  living" 
and  of  efficient  methods  of  prevention  and  treatment  of  a  widespread 
disease.     This  advantage  was  considered  of  utmost  importance. 

4.  Accessibility    of    the    institution    to    the   general    medical    pro- 
fession of  Chicago,  permitting  the  establishment  of  a  link  between  the 
family  physician  and  the  Sanitarium,  and  placing  the  medical  staff  of 
the  institution  in  closer  contact  with  the  medical  organizations  and  insti- 
tutions and  their  leaders  in  a  large  city. 


16  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

With  the  appreciation  of  these  important  conditions  in  favor  of  the 
location  of  the  Sanitarium  within  the  city  limits,  it  was  decided  to  look 
at  once  for  the  right  location.  This  task  consumed  a  period  of  eight 
months,  during  which  every  section  of  the  city  was  thoroughly  canvassed 
by  real  estate  concerns,  the  Sanitarium  Board  and  the  General  Office. 
Numerous  acceptable  locations  were  submitted  to  the  Board  but  as  a  rule 
the  prohibitive  price  or  the  objection  of  the  neighboring  property  owners 
stood  in  the  way  of  actual  purchase. 

The  campaign  for  the  acquisition  of  a  suitable  site  for  the  Sani- 
tarium was  one  of  continuous  argumentation  between  the  adherents  and 
opponents  of  location  of  the  institution  within  the  city  limits. 

In  the  course  of  this  campaign  two  occasions  furnished  the  desired 
opportunity  for  a  full  discussion  of  the  situation  as  viewed  by  both  sides. 

The  first  occasion  came  when  an  eighty-five  acre  tract  of  land,  situ- 
ated in  the  northern  section  of  the  City,  was  submitted  to  the  Board  for 
consideration.  The  purchase  had  almost  been  completed  when  property 
owners  within  a  radius  of  two  miles  organized  in  a  violent  opposition  to 
the  plan.  The  tract  possessed  a  number  of  desirable  features :  viz., 
accessibility,  good  drainage,  a  large  grove  of  trees,  etc. ;  the  price  was 
moderate  and  the  Board  was  inclined  to  purchase  the  land.  To  prevent 
this,  the  matter  was  carried  to  the  Finance  Committee  of  the  City  Council, 
whose  consent  was  essential  to  purchase  of  any  property  by  the  Sani- 
tarium. This  appeal  to  the  Finance  Committee  brought  together  for  the 
first  time  both  sides  for  an  earnest  discussion  of  the  situation.  On  Sep- 
tember 28,  1910,  the  Finance  Committee,  accompanied  by  the  Sanitarium 
Board  and  a  number  of  owners  of  adjacent  property,  visited  the  pros- 
pective site.  Most  of  the  land  was  acre  property  used  for  truck  garden- 
ing. The  site  was  inspected,  and  this  was  followed  by  a  public  hearing 
before  the  Finance  Committee.  Arguments  against  locating  the  institu- 
tion at  the  above  mentioned  site  were  first  submitted  by  the  representa- 
tives of  the  opposition.  The  chief  objections  were  the  possible  spread 
of  infection  from  the  institution  to  surrounding  territory  and  the  prob- 
able decline  in  neighboring  property  values.  It  was  soon  apparent  that 
the  attitude  toward  the  proposed  institution  was  one  of  frantic  fear  based 
on  misconception.  This  afforded  an  excellent  opportunity  for  imparting 
information  on  this  subject  to  the  protesting  parties,  as  well  as  to  the 
entire  community.  Strong  arguments  were  submitted  in  support  of  the 
fact  that  sanitaria  are  not  sources  of  infection,  that  their  presence  in  a 
community  leads  to  a  decline  of  tuberculosis  prevalence  and  that  real 
estate  values  in  its  vicinity  generally  rise,  as  shown  by  the  experience  of 
other  cities.  The  discussion  was  lengthy  and  spirited,  with  the  Board 
steadily  gaining  ground  in  the  gradual  elimination  of  the  arguments  of 
the  opposition.  When  it  became  evident  that  the  Finance  Committee 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  17 

might  approve  the  prospective  purchase,  the  representatives  of  the  op- 
position came  forward  with  an  offer  to  find  another  site  for  the  Sani- 
tarium within  a  month. 

It  became,  however,  apparent  to  all  the  interested  parties  that  the 
City  of  Chicago  was  determined  to  build  the  Sanitarium,  in  accordance 
with  the  decision  of  the  voters,  who  had  adopted,  by  an  enormous  ma- 
jority, the  provisions  of  the  Municipal  Sanitarium  Law. 

An  energetic  search  for  a  suitable  location  was  begun  again  by  the 
Board  and  various  real  estate  firms,  as  well  as  by  the  opponents  of  the 
location  of  the  institution  at  the  site  previously  selected.  Finally,  an  offer 
of  a  suitable  site  was  submitted  on  December  7,  1910,  and  on  December 
16,  the  Board  requested  the  Finance  Committee  of  the  City  Council  to 
purchase  the  property.  This  site,  on  which  the  Sanitarium  was  finally 
built,  consisted  of  160  acres  of  farm  land  situated  about  9  miles  from  the 
center  of  the  City,  between  North  Crawford  Avenue  on  the  west,  North 
Central  Park  Avenue  on  the  east,  and  Peterson  and  Bryn  Mawr  Avenues 
on  the  north  and  south,  respectively.  The  site  was  inspected  on  Decem- 
ber 20  by  the  Finance  Committee,  accompanied  by  the  Sanitarium  Board 
and  this  was  followed  by  two  public  hearings  before  the  Committee,  one 
on  January  16  and  another  on  January  20,  1911. 

The  arguments  previously  used  by  the  opposition  were  forcibly  re- 
iterated at  these  hearings  by  the  owners  of  neighboring  property,  mostly 
vacant.  In  brief,  the  weight  of  the  argument  centered  again  around  the 
possibility  of  spread  of  infection  from  the  Sanitarium  to  surrounding 
territory  and  the  probable  decline  in  land  values  around  the  institution. 
The  objections  were  easily  allayed  by  recital  of  experiences  of  various 
other  cities  in  this  country  and  Europe,  where  the  building  of  sanitaria 
generally  led  to  reduction  of  death  rate  from  tuberculosis  in  the  vicinity 
of  tuberculosis  institutions  as  well  as  an  increase  in  land  values.  The 
discussion  was  lengthy  and  spirited. 

The  verdict  of  the  Finance  Committee  was  ultimately  rendered  in 
favor  of  the  Sanitarium,  and  on  January  30,  1911,  an  order  to  purchase 
the  property  was  passed  by  the  City  Council. 

This  ended  the  memorable  8  months'  campaign  of  the  Board  of  the 
Municipal  Tuberculosis  Sanitarium  to  acquire  a  site  for  this  much 
needed  institution. 

The  work  of  preparation  of  plans  of  the  Sani- 

The  Preparation  tarium  was  begun  under  the  direction   of  Dr. 

of  Plans  Theodore  B.  Sachs,  Chairman  of  the  Committee 

of  Plans,  on  March  1,  1911.     On  May  2,  1911, 

the  Board  of  Directors  appointed  Messrs.  William  A.  Otis  and  Edin  H. 
Clark,  Architects  of  the  Sanitarium. 


18  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

The  work  proceeded,  through  a  period  of  two  years,  in  daily  sessions 
of  the  Chairman  of  the  Committee  on  Plans,  the  Architect,  Mr.  Otis,  and 
Frank  E.  Wing,  who  acted  as  Secretary  of  the  Committee,  the  plans 
being  submitted  from  time  to  time  to  the  Board  of  Directors  for  ap- 
proval and  suggestions. 

In  the  general  scheme  of  the  institution,  the  experience  gained  in 
the  preceding  several  years  in  building  sanitaria  near  Chicago  was  exten- 
sively supplemented  by  an  intensive  study  of  various  phases  of  sanitarium 
construction  all  over  the  country.  Plans  were  gathered  from  leading 
tuberculosis  institutions.  These  were  thoroughly  studied  and  the  inform- 
ation bearing  upon  various  phases  of  construction  was  classified, 
analyzed,  and  later  drawn  upon,  through  the  entire  period  of  planning 
the  institution. 

The  site  purchased  for  the  Sanitarium  was  devoid  of  any  improve- 
ments and  these  had  to  be  included  in  the  general  plans. 

First,  the  character  and  number  of  cases  to  be  served  by  the  pro- 
posed institution  was  agreed  upon,  this  determining  the  character  and 
extent  of  the  necessary  provisions. 

Then,  the  grouping  of  buildings  was  outlined  with  a  full  considera- 
tion of  the  general  appearance,  facility  of  administration  and  comfort  of 
patients.  The  last  point  involved  the  solution  of  several  important  ques- 
tions in  an  institution  consisting  of  a  group  of  detached  buildings:  viz., 
distances  between  the  administration  buildings  and  patients'  cottages, 
distances  between  cottages,  their  right  exposure  and  such  position  as 
would  give  the  patients  the  utmost  privacy  and  quietude  consistent  with 
facility  of  supervision.  The  position  of  the  patients'  cottages,  finally 
decided  upon,  completely  isolates  them  from  the  surrounding  neigh- 
borhood. 

The  respective  position  of  the  administration  buildings  and  the 
patients'  cottages  was  finally  so  arranged  that  the  line  of  administration 
and  infirmary  buildings,  from  west  to  east,  divides  the  Sanitarium 
grounds  into  two  separate  sections — one  for  the  male  and  the  other  for 
the  female  patients.  Each  section  has  its  own  large  recreation  grounds. 
The  total  area  occupied  by  the  Sanitarium  buildings  is  approximately 
45  acres,  leaving  115  acres  for  produce  farm  and  future  buildings. 

In  the  preparation  of  plans  of  the  open  air  cottages  for  adult  patients, 
a  thorough  study  was  made  of  the  plans  of  similar  structures  in  other 
institutions  all  over  the  country.  This  type  of  cottage  was  originally 
introduced  by  Dr.  H.  M.  King  in  the  Loomis  Sanatorium  at  Liberty, 
New  York,  and  has  been  adopted  with  various  modifications,  in  a  num- 
ber of  institutions.  Important  modifications,  made  in  the  arrangements 
of  this  cottage  in  the  Edward  Sanatorium,  Naperville,  Illinois,  and  other 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  19 

sanitaria  were  fully  considered  in  the  final  evolvement  of  the  plans  of 
the  cottages  for  the  Chicago  institution.  In  its  final  form  the  Open  Air 
Cottage  of  the  Chicago  Municipal  Tuberculosis  Sanitarium  contains  a 
number  of  important  modifications. 

The  plan  of  the  cottages  for  children  had  to  be  originally  devised, 
as  this  special  type  of  provision  was  practically  not  in  existence  any- 
where at  the  time  the  plans  were  drawn. 

The  plans  of  the  administration  building  were  made  compre- 
hensive in  order  to  include  all  the  modern  medical  and  laboratory  facili- 
ties for  the  diagnosis  and  treatment  of  the  disease  and  its  complications. 

Considerable  time  was  spent  in  planning  the  Service  Building  and 
Dining  Halls  with  reference  to  adequacy  and  efficiency  of  service. 

The  underlying  idea  in  the  plans  of  the  Infirmary  was  that  a  large 
percentage  of  patients  admitted  here  will  need  hospital  bedside  care, 
that  the  condition  of  these  patients  will  necessitate  utmost  quietude,  and 
frequently  isolation  from  each  other.  With  this  idea  in  mind,  the 
quarters  for  patients  in  this  part  of  the  institution  were  divided  into 
three  classes,  about  one-third  of  the  provision  consisting  of  single  rooms, 
one-third  double  rooms,  and  one-third  open  air  wards  of  six  beds  each. 
The  Infirmary  includes  also  special  medical  and  laboratory  facilities. 

The  plans  of  quarters  for  the  employes  were  so  designed  as  to  pro- 
vide outdoor  sleeping  porches  for  at  least  one-third  of  the  working  force. 
Large  windows,  from  3  feet  by  6  feet  to  3  feet  10  inches  by  6  feet  8 
inches,  were  provided  in  all  employes'  rooms. 

The  floor  plans  and  the  elevations  were  minutely  studied  and  the 
final  plans  of  each  building  were  carefully  adjusted  to  the  general  scheme 
of  efficient  and  economic  care  of  patients. 

In  drawing  the  plans  of  this  immense  institution,  the  advice  of  many 
men,  prominent  in  special  lines  of  work,  was  sought  and  the  work  was 
carried  on  with  close  cooperation  of  the  original  and  present  Boards  of 
Directors  of  the  Sanitarium,  the  membership  of  which  included  orig- 
inally, Harlow  N.  Higinbotham,  President;  Dr.  Theodore  B.  Sachs, 
Secretary,  and  Dr.  William  A.  Evans,  and  later  Dr.  Theodore  B.  Sachs, 
President ;  Dr.  George  B.  Young,  Secretary,  and  W.  A.  Wieboldt. 


20  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


DESCRIPTION  OF  THE  SANITARIUM 

The  Sanitarium  occupies  an  area  a  half  mile 

The  Grounds  square  in  the  extreme  northwest  section  of  the 

city,  at  the  corner  of  North  Crawford  and  Bryn 

Mawr  Avenues,  about  nine  miles  from  the  downtown  district.  Formerly 
a  number  of  small  farms  composed  this  tract  of  land.  The  soil  is  black 
clay  loam,  well  suited  for  farming  purposes.  After  the  purchase  of  this 
site,  the  ground  was  thoroughly  drained  by  placing,  through  the  entire 
area,  traversing  lines  of  farm  tile,  at  distances  varying  from  50  to  100 
feet  apart. 

Large  groves  of  trees  are  found  on  the  east  and  northwest  sections 
of  the  tract,  as  well  as  at  the  southwest  corner,  at  the  entrance  to  the 
Sanitarium. 

A  nursery  acquired  with  the  land,  consisting  of  about  5,000  trees 
and  shrubs  of  various  kinds,  was  subsequently  used  for  transplanting  on 
the  lawns  and  along  the  roads  and  walks.  Later,  an  additional  supply 
was  purchased  to  complete  the  improvement.  A  20-foot  border  of  trees 
and  shrubs  was  planted  around  the  grounds  to  furnish  isolation  from 
the  surrounding  territory. 

Water  supply  was  obtained  by  extending  the  city  main,  at  the  ex- 
pense of  the  Sanitarium,  a  distance  of  2,540  feet,  to  the  entrance  of  the 
Sanitarium  grounds.  The  Sanitarium  bore  its  pro  rata  expense  of  con- 
structing new  sewerage  lines  for  the  drainage  of  the  grounds  and  the 
surrounding  territory. 

The  work  of  improving  the  grounds  was  done  under  the  direction 
of  O.  C.  Simonds  &  Company,  Landscape  Gardeners.  The  same  firm  had 
the  supervision  of  the  construction  of  driveways  and  walks  connecting 
the  various  buildings  of  the  Institution  from  one  end  of  the  grounds  to 
the  other. 

At  the  time  of  opening  the  Institution,  the  entire  area  occupied  by 
the  Sanitarium  buildings  was  well  graded  and  covered  with  trees,  shrubs 
and  flowering  plants,  around  the  various  buildings  and  along  the  asphaltic 
macadam  roads  and  walks  which  extend  through  the  grounds.  The  sur- 
rounding belt  of  about  80  acres  is  plowed  and  ready  for  farming.  The 
grounds  are  enclosed  by  a  temporary  fence,  with  an  ornamental  main 
entrance  at  the  corner  of  Bryn  Mawr  and  Crawford  Avenues  and  a  spe- 
cial service  entrance  at  Peterson  Avenue. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


CITY  OF  CHICAGO 

;  MVN1CI PAL TYBERCVLOSIS  SANITARIVM    ° 


NOT*  CBAWrOBD 


The  Layout 
of  Buildings 


Layout  of  the  Sanitarium  Buildings  and  Grounds 

In  the  layout  of  the  Sanitarium,  the  Adminis- 
tration Building,  Service  Building,  Dining  Halls, 
Infirmary  Group  and  Power  House  were  placed 
along  the  median  line  of  the  grounds,  running 

from  west  to  east.  This  line  divides  the  grounds  into  two  sections :  the 
south  section  reserved  for  the  cottages  for  ambulant  women  patients ;  the 
north  section,  for  men.  The  entire  group  of  Sanitarium  buildings  is  so 
placed  as  to  leave  a  broad  stretch  of  ground  on  the  north,  east  and  south 
sides  for  farming  and  gardening. 

All  the  buildings  located  in  the  median  line  face  west  with  the  excep- 
tion of  the  Infirmary  wings  and  the  two  Dining  Halls,  the  exposures  of 
which  are  south.  They  are  all  connected  by  a  spacious  service  tunnel 
running  a  distance  of  1,500  feet. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


The  Administration  Building  comes  first,  reached  from  the  main 
entrance  to  the  grounds  by  a  driveway  1,400  feet  long.  This  building  is 
removed  800  feet  from  North  Crawford  Avenue. 

Next,  100  feet  east  of  the  Administration  Building  comes  the  Dining 
Hall  for  men  patients,  the  Service  Building  and,  east  of  it,  the  Dining 
Hall  for  women  patients.  These  buildings  are  connected  by  enclosed 
corridors  and  form  by  their  position  a  cross  (  +  ),  the  horizontal  line 
representing  the  Service  Building. 

One  hundred  and  twenty-five  feet  from  the  Women's  Dining  Hall 
comes  the  group  of  Infirmary  buildings,  consisting  of  an  Administration 
building  and  two  wings,  forming  by  their  position  the  letter  "H."  The 
Infirmary  has  a  capacity  of  about  300  beds. 

The  Power  House  and  Laundry  is  at  the  extreme  eastern  point  of 
the  median  line  of  buildings,  placed  at  a  distance  of  500  feet  from  the 
Infirmary. 

The  Open  Air  Cottages  for  ambulant  men  and  women  patients,  with 
a  Unit  Administration  Building  in  the  center  of  each,  form  two  separate 
groups  of  buildings,  one  on  the  south  and  the  other  on  the  north  side  of 
the  grounds. 

Of  the  ultimate  number  of  twenty-eight  cottages,  twenty  are  for 
adults  and  eight  for  children.  The  cottages  face  southeast,  this  position 
furnishing  the  best  protection  against  the  prevailing  northwest  winds. 
They  are  100  feet  apart,  from  end  to  end,  and  are  placed  in  rows  sep- 
arated by  lawns  125  feet  wide.  The  distance  between  the  cottages  and 
the  central  group  of  administration  buildings  varies  from  175  to  600 
feet. 

At  the  opening  of  the  Institution  in  March,  1915,  there  were  twelve 
cottages  for  ambulant  adult  patients  and  four  cottages  for  children,  with 
the  total  capacity  of  about  380  beds.  Eight  cottages  for  adults  and  four 
for  children  are  to  be  added  this  year,  increasing  the  number  of  beds 
for  ambulant  cases  to  650.  All  the  administrative  facilities  for  these 
additional  cottages  have  been  provided. 

The  Nurses'  Building  is  in  the  southwest  section  of  the  grounds, 
situated  within  600  feet  from  the  main  entrance  and  is  so  placed  as  to 
give  the  nurses  the  necessary  privacy  and  quietude. 

The  Garage,  Farmhouse  and  Barns  are  placed  at  the  extreme  eastern 
point  of  the  grounds,  within  a  distance  of  116  feet,  272  and  124  feet,  re- 
spectively, from  the  Power  House.  Additional  farm  buildings  will  be 
erected  later,  south  of  this  group. 

Space  for  a  Chapel  is  reserved  at  a  point  west  of  the  main  adminis- 
tration buildings.  This  is  designated  on  the  block  plan  on  page  21. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  23 

The  quarters  for  the  Superintendent  are  for  the  present  on  the 
second  floor  of  the  main  Administration  Building.  A  separate  Superin- 
tendent's Residence  will  be  built  in  the  near  future  in  the  southwest  sec- 
tion of  the  grounds  across  the  main  driveway,  opposite  the  Nurses'  Home. 

The  north  border  of  the  grounds,  with  the  wide  open  space  south 
of  it,  is  reserved  for  future  hospital  buildings  which  will  be  needed  with 
the  growth  of  the  Institution. 

The  Chicago  Municipal  Tuberculosis  Sanitarium 

The  Provisions  of  was  so  planned  as  to  gradually  meet  the  needs 
the  Chicago  Mu-  of  the  tuberculosis  situation  in  a  growing  city 

nicipal  Tuberculosis  which  has  at  present  a  population  of  two  and  a 
Sanitarium  half  million.  The  administrative  facilities  of 

the  institution  are  arranged  to  care  for  a  total 

of  from  900  to  950  patients ;  these  facilities  can  be  further  extended.  As 
the  average  period  of  stay  of  a  favorable  tuberculosis  case  varies  from 
four  to  six  months,  it  is  expected  that  the  Sanitarium,  in  its  present  state, 
will  be  in  a  position  to  care  for  about  1,500  to  2,000  patients  annually. 


24 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


MUNICIPAL  SANITARIUM  GROUNDS 
iRAWFOED  £  BRYM  MAW*  AVE. 

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5T.  ELIZABETH      . 

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WEST  SIDE 
MAXWELL  C  MILLERS 


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IROQUO1S  MEMORIAL 
"23  N.  MARKET  ST 

..OENEftAL  OFFICE 
J  0.5  W.  MONROE  ST 


MAP  OF  CHICAGO 

SHOWING 

DISTRICTS 

SERVED  BY 

MUNICIPAL  TUBERCULOSIS 
DISPENSARIES         * 

0 

P&tients  sAou/d  attend  G 

th  e  Dispensary  lo  ca  ted " 

in  the  district  in  wA/cA 

they  Jive  

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The  Gzner&l  Office 
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POST  GRADUATE 


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Map  Showing  Location  of  the  Ten  Free  Dispensaries  of  the 
Municipal  Tuberculosis  Sanitarium 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  25 

SOME  IMPORTANT  FEATURES  OF  THE  ORGANIZATION 

OF  THE  CHICAGO  MUNICIPAL  TUBERCULOSIS 

SANITARIUM 

I.      THE   CHICAGO   MUNICIPAL  TUBERCULOSIS   SANITARIUM   IS  A   MUNICIPAL 

ORGANIZATION    OF   A    SANITARIUM,   DISPENSARIES   AND 

OTHER  AUXILIARY  AGENCIES  ESSENTIAL  IN 

CONTROL  OF  THE  DISEASE 

1.  The  Dispensary  Department,  a  very  important  department  of 
the  Sanitarium,  maintains  at  present  ten  municipal  tuberculosis  dis- 
pensaries. Gradually  developed  out  of  small  beginnings  in  the  latter 
part  of  the  year  1907,  the  dispensaries  have  grown  into  a  comprehensive 
administrative  machinery  for  the  prevention  and  control  of  tuberculosis 
in  this  city.  While  adequate  hospital  and  sanitarium  provision  for  the 
care  of  tuberculous  patients  is  a  very  important  factor  in  the  gradual 
solution  of  the  tuberculosis  situation  in  any  community,  the  magnitude 
of  the  problem  in  its  various  relations  to  the  home,  the  family  and  the 
community  at  large  requires  the  operation  of  a  comprehensive  adminis- 
trative scheme,  the  function  of  which  should  be  the  control  and  preven- 
tion of  the  disease  in  the  environment  of  the  patient  as  well  as  painstak- 
ing, persistent  education  of  the  sufferer,  of  those  about  him,  as  well  as  of 
the  people  at  large,  on  the  general  subject  of  maintenance  of  health,  pre- 
vention of  the  disease  and  the  right  method  of  care  of  those  afflicted.  It 
falls  to  the  dispensaries  to  perform  that  important  task  in  the  campaign 
against  the  disease — to  teach  the  community  the  far  reaching  effect  of 
early  recognition  of  tuberculosis  and  early  application  of  right  remedial 
measures. 

The  dispensaries  bear  also  an  important  relation  to  tuberculosis 
hospitals  and  sanitaria,  in  the  matter  of  proper  selection  of  cases  and 
efficient  supervision  of  the  discharged  patients. 

Thus  the  function  of  the  dispensaries  embraces  the  following: 

(a)  Education  of  the  patient  and  the  community  on  the  subject 
of  prevention,  early  recognition  and  right  methods  of  treatment  of  the 
disease. 

(b)  Right  distribution  of  cases  requiring  institutional  treatment 
among  the  special  hospitals  and  sanitaria  of  the  community. 

(c)  Supervision  of  the  large  number  of  cases  which  have  to  be 
treated  at  home  either  before  admission  to  an  institution,  or  subsequent 
to  discharge,  also  cases  in  which  institutional  treatment  is  impossible  for 
various  reasons,  such  as  insufficiency  of  the  existing  institutional  pro- 
vision, family  conditions,  etc. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


One  of  the  Ten  Municipal  Tuberculosis  Dispensaries  in   Operation. 
Stock  Yards  Dispensary,  738  West  Forty-seventh  Street 


The  Chicago  tuberculosis  dispensaries  were,  in  their  earliest  days 
of  development,  conducted  in  connection  with  the  district  offices  of  the 
Bureau  of  Charities,  with  a  personnel  of  volunteer  physicians.  This 
arrangement,  however,  proved  soon  unsuitable  for  a  great  many  reasons, 
among  which  inadequacy  of  space  and  lack  of  essential  and  auxiliary 
medical  facilities  were  the  most  important. 

The  dispensaries  were  later  placed  by  the  Chicago  Tuberculosis 
Institute  in  connection  with  a  few  colleges  and  hospitals  of  this  city,  this 
arrangement  proving  of  inestimable  value  from  various  standpoints,  such 
as  the  advantage  accruing  from  close  connection  with  other  special 
departments  of  a  medical  institution,  the  instruction  of  students,  etc. 

Two  factors,  however,  continued  to  stand  in  the  way  of  development, 
namely:  inability  to  secure  sufficient  space  and  the  impossibility  of  com- 
plete control  of  agencies  affiliated  with  organizations  which  in  the  exer- 
cise of  their  authority  and  the  realization  of  their  own  functions,  were 
unable  to  extend  to  the  tuberculosis  dispensaries  that  degree  of  latitude 
essential  to  uniformity  of  work. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


FLOOR  PLAN  OF 
MUNICIPAL  TUBERCULOSIS  DISPENSARY 

IN  THE 

HOUSE  OF  SOCIAL  SERVICE -STOCKYARDS  DISTRICT 

THE  UNITED  CHARITIES  OF  CHICAGO 

738  WEST  47*s  STREET 


When  the  Municipal  Tuberculosis  Sanitarium  acquired  the  eight 
dispensaries  from  the  Chicago  Tuberculosis  Institute  in  1910,  the  inevit- 
able conclusion  was  soon  reached  that  the  development  of  the  Municipal 
Tuberculosis  Dispensary  System  in  Chicago  would  be  greatly  facilitated 
by  placing  these  institutions  in  suitable  quarters  absolutely  controlled  by 
the  City.  Of  the  ten  dispensaries  at  present  in  operation,  two  are  in 
affiliation  with  medical  colleges,  three  with  hospitals,  one  is  in  connection 
with  a  general  dispensary,  three  are  in  rented  quarters  which  were  re- 
modeled by  the  Sanitarium  to  fulfill  the  various  requirements  of  a  tuber- 
culosis clinic,  and  one  is  housed  in  The  House  of  Social  Service  of  the 
Stock  Yards  District  of  the  United  Charities,  during  the  construction  of 
which  the  Board  of  Directors  of  the  Sanitarium  contracted  for  1,456 
square  feet  of  space  and  were  permitted  to  lay  out  their  own  plans  of  a 
dispensary,  which  at  present  ranks  above  the  other  dispensaries  in  its 
architectural  arrangements. 


28 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


The  present  plan  is  to  gradually  centralize  in  a  few  dispensaries, 
housed  in  special  buildings  constructed  by  the  city.  The  first  step  in  this 
direction  is  the  proposed  South  Side  Central  Municipal  Tuberculosis 
Dispensary,  which'  is  to  include  the  very  comprehensive  medical,  labora- 
tory and  X-Ray  facilities  essential  in  the  diagnosis  and  treatment  of 
cases.  This  dispensary  will  include  the  following  provisions: 


First  floor 

Entrance  waiting  room 

Registration  and  clerical  office 

Head  Nurse's  office 

Two  Consultation  rooms 

Two  Patients'  waiting  rooms 

Four  Examining  rooms  with  ad- 
joining dressing  rooms 

Surgical  room 

Orthopedic  room 

X-Ray   room 

Dental  room 

Nose  and  Throat  room 

Laboratory 

Drug  room 

Janitor's  living  quarters 

Separate  lavatories  and  toilet 
rooms  for  patients  and  em- 
ployes 


Basement — 

Large  storerooms  for  supplies,  mattresses,  bedding  and  other  outdoor 
sleeping  equipment;  disinfecting  room;  boiler  and  machinery  room. 


Second  flpor 

Exhibition  room,  29  feet  by  34 
feet 

Open  Air  -School  of  instruction, 
for  17  male  and  17  female  pa- 
tients, where  patients,  by  dem- 
onstration, will  be  taught  the 
essentials  of  prevention  and 
"cure" 

Nurses'  office 

Kitchen  and  serving  pantry 

Patients'  dining  room 

Nurses'  lunch  room 

Patients'  locker,  bath  and  toilet 
rooms 


Kfr  M  mi 

mm, mm.  to 


Proposed  Central  South  Side  Municipal  Tuberculosis  Dispensary 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


First  Floor 


QDDD 

DAY- CAMP 

DDtrai: 


DDDDD 

DAY- CAMP 

:nntttin 
innnnn 


DLCO/^D- FLOOD 


CMffiAL  JOUTH-JIDL  IUDKCULCJ1J  D1JPKA5AJ2Y 

Of  TM 

MWI1CIPAI  TVM2CVI/OJIJ  JA/il!ARIVA. 
CHICAGO  ILlIJiOIJ. 


Second  Floor 


Floor  Plans  of  Proposed  Central  South  Side  Municipal  Tuberculosis  Dispensary 


30 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


West  Side 


Policlinic 


Grand  Crossing 


South  West 


St.  Elizabeth 


Iroquois 


Interior  Views  of  Some  of  the  Ten  Free  Tuberculosis  Dispensaries  Maintained 
by  the  Chicago  Municipal  Tuberculosis  Sanitarium 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  31 

The  dispensaries  of  the  Chicago  Municipal  Tuberculosis  Sanitarium 
have  steadily  grown  in  the  matter  of  the  gradual  realization  of  municipal 
control  of  the  disease  in  this  city  as  shown  by  the  following  table : 

1907    1908      1909      1910       1911     1912      1913      1914  Total 

Number  of  dispen- 
saries    6  7  7  8  9  10  10  10 

Number    of    nurses..        67  8          11          23          31          34          45 

Number    of    patients 

under     observation      4,943     9,159  12,598  14,972 

Number  of  new  pa- 
tients (first  exam- 
inations)   1552,320  3,181  4,069  3,953  5,039  6,532  7,127  32,576 

Number  of  positive 
diagnoses  (all 
forms)  2,151  2,795  3,538  8,484 

Number  of  visits  by 
patients  to  dispen- 
saries   16,012  22,239  26,284  29,609  43,989  52,244  190,877 

Number    of    nurses' 

visits     14,393   19,025  31,980  42,335  39,737  46,183   193,653 

At  present  the  ten  Municipal  Tuberculosis  dispensaries  have  a  per- 
sonnel of  thirty-one  physicians,  one  bacteriologist,  one  superintendent 
of  field  nurses,  one  supervising  field  nurse,  ten  head  field  nurses,  forty- 
seven  field  nurses,  one  interpreter,  two  stenographers,  two  clerks,  and  one 
messenger,  all  selected  by  competitive  Civil  Service  examination. 

The  dispensaries  are  at  the  following  locations : 

NORTH  SIDE 

CHICAGO  POLICLINIC,  221  West  Chicago  Avenue 
Tuesdays,  Fridays  and  Saturdays,  9  a.  m.  to  12  m. 

SOUTH   SIDE 
POST-GRADUATE,  2400  Dearborn  Street 

Tuesdays  and  Thursdays,  10  a.  m.  to  12  m. 

Children's  Clinic:     Saturdays,  10  a.  m.  to  12  m. 
GRAND  CROSSING,  942  East  Seventy-Fifth  Street 

Mondays  and  Thursdays,  2  to  5  p.  m. 
PROVIDENT,  57  West  Thirty-Sixth  Street 

Mondays  and  Thursdays,  2:30  to  5:30  p.  m. 
STOCKYARDS,  738  West  Forty-Seventh  Street 

Tuesdays  and  Saturdays,  9  a.  m.  to  12  m. 
DOWN  TOWN 
IROQUOIS  MEMORIAL,  23  North  Market  Street 

Tuesdays,  7  to  10  p.  m.;  Saturdays,  2  to  5  p.  m. 

WEST   SIDE 
ST.  ELIZABETH,   Blackhawk  Street  and  North  Ashland  Avenue. 

Mondays  and  Thursdays,  9  a.  m.  to  12  m. 
CENTRAL  FREE,  1744  West  Harrison  Street 

Wednesdays  and  Saturdays,  9  a.  m.  to  12  m. 
WEST  SIDE  DISPENSARY,   Corner  Maxwell  and  Miller  Streets 

Mondays  and  Tuesdays,  2  to  5  p.  m. 

Thursdays,  9  a.  m.  to  12  m. 

Children's  Clinic:     Saturdays,  9  a.  m.  to  12  m. 
SOUTHWEST,  2406  West  Twenty-Second  Street 

Mondays  and  Thursdays,  1  to  4  p.  m. 

Wednesdays  and  Saturdays,  1  to  3  p.  m. 

Evening  Clinic:    Thursdays,  7  to  9  p.  m. 


32 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


'  EXAMINING 
R.OOM 

U-6"xj2'-5" 


EXAMINING 

R.OOM 

IZ-2"*  14--7" 


WAITING  R.OOM 
I7J2-X22-6" 


Floor   Plan   of   the   Municipal   Tuberculosis    Clinic   in   the    Emanuel    Mandel 

Memorial  Dispensary  of  the  Jewish  Aid  Society,  Corner 

Maxwell  and  Miller  Streets 

2.  Bureau  of  Special  Relief  of  the  Dispensary  Department,  in- 
augurated April  14,  1914,  the  function  of  which  is  provision  of  means 
for  outdoor  treatment  in  homes  of  tuberculous  patients,  for  the  purpose 
of  benefiting  the  patient  and  protecting  the  family  from  infection.  The 
Bureau  concerns  itself  with  remodeling  and  building  inexpensive  outdoor 
sleeping  porches  and  furnishing  such  accessories  as  beds,  bed  clothing, 
reclining  chairs,  canvas  curtains,  etc. 

This  is  the  first  municipal  undertaking  of  its  kind  in  the  United 
States.  The  possibilities  of  this  undertaking,  efficiently  and  economically 
managed,  are  no  doubt  very  great  in  the  field  of  municipal  control  of 
tuberculosis. 

The  work  was  undertaken  by  the  Dispensary  Department  of  the 
Municipal  Tuberculosis  Sanitarium  in  July,  1914,  after  a  thorough  study 
of  the  provisions  of  the  Sanitarium  Law  and  numerous  conferences  with 
representatives  of  charity  organizations.  The  Sanitarium  adopted  the 
policy  of  limiting  its  relief  work  to  supplying  the  needy  tuberculous 
patients  with  the  "facilities  of  treatment,"  this  work  leading  to  the 
organization  of  the  Bureau  of  Special  Relief  above  mentioned. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


33 


Before 


A  Second  Story  Porch 


Porch  at  Stair  Landing 


After 


Shelter  on  a  Roof 


Canvas  Curtains  Furnished 


ARRANGING  AND  BUILDING  PORCHES  FOR  OUTDOOR  SLEEPING 

Examples  of  Work  Done  in  Various  Sections  of  the  City  by  the  Bureau  of 
Special  Relief  of  the  Dispensary  Department  of  the  Chicago 
Municipal  Tuberculosis  Sanitarium 


34  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

The  Law  provides  that  the  "Board  shall  have  the  power  to  extend 
the  benefits  and  privileges  of  such  institution  (meaning  the  Sanitarium) 

.    .    .    .    .    into  the  homes  of  persons  afflicted  with  tuberculosis " 

The  clause,  properly  interpreted,  has  reference  to  the  essentials  of  the 
modern  treatment  of  the  disease  (such  as  outdoor  sleeping  arrangements, 
additional  bedclothing  necessary  in  cold  season,  etc.)  ;  it  can  not  be  inter- 
preted as  including  "general  relief"  of  poverty  caused  by  the  disease,  this 
important  task  still  remaining  within  the  province  of  official  and  private 
relief  agencies. 

3.     Education  by  Literature  and  Exhibits.    This  consists  of : 

a.  Distribution  of  small  leaflets  bearing  on  early  diagnosis  of  tu- 
berculosis and  giving  location  and  hours  of  the  ten  Municipal  Tuber- 
culosis  Dispensaries.     Similar  leaflets  in   reference  to  other   important 
phases  of  the  problem,  for  circulation  among  patients,  are  being  prepared 
by  the  Dispensary  Department. 

b.  Publication  of  Bulletins.    The  first  bulletin  -published  by  the 
Dispensary  Department  contained  papers  on  various  phases  of  the  tuber- 
culosis problem  read  by  Field  Nurses  at  the  meetings  of  their  Nurses' 
Tuberculosis   Study  Circle.     The  individual  papers  were:     "Historical 
Notes   on   Tuberculosis"   by   Miss   Rosalind   Mackay,   R.   N. ;   "Visiting 
Tuberculosis  Nursing  in  Various  Cities  of  the  United  States"  by  Miss 
Anna  M.  Drake,  R.  N. ;  "Provisions  for  Outdoor  Sleeping"  by  Miss  May 
MacConachie,  R.  N. ;  "Some  Points  in  the  Nursing  Care  of  the  Advanced 
Consumptive"  by  Miss  Elsa  Lund,  R.  N. ;  "Open  Air  Schools  in  This 
Country  and  Abroad"  by  Miss  Frances  M.  Heinrich,  R.  N. 

The  second  bulletin  of  the  Dispensary  Department  is  being  prepared 
now.  It  will  contain  "Instructions  to  Field  Nurses  in  the  Dispensary 
Department,"  having  reference  to  various  phases  of  their  work  and 
methods  of  cooperation  with  other  organizations. 

It  is  planned  that  this  "History  and  Description  of  the  Sanitarium," 
should  be  the  first  bulletin  of  the  Sanitarium  Department,  this  to  be  fol- 
lowed by  the  publication  of  other  bulletins  bearing  upon  the  Sanitarium 
work. 

c.  Co-operation  in  maintaining  the  Tuberculosis  Exhibit  of  the 
Chicago  Tuberculosis  Institute  which  in  a  period  of  266  exhibit  days 
was  shown  in  field  houses  of  fifteen  small  parks  and  in  five  public 
schools,  the  exhibit  being  viewed  by  307,500  people. 

The  exhibit  with  its  daily  conferences,  its  entertainments,  planned 
to  attract  large  audiences,  will  be  continued  for  one  week  periods  in  va- 
rious public  schools  of  Chicago  until  the  end  of  the  present  school  year. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


35 


In  addition  to  this  exhibit,  special  tuberculosis  exhibits  were  prepared  by 
the  Municipal  Tuberculosis  Sanitarium  for  the  Housing  Exhibit  (1912) 
and  the  Public  Health  Exhibit  (1914),  both  held  in  the  City  Club. 


The  gradual  development  of  the  scheme  of  control  of  tuberculosis 
in  Chicago  under  the  provisions  of  the  Municipal  Tuberculosis  Sanitarium 
makes  the  dispensaries  the  agencies  for  early  detection  and  control  of  the 
disease  in  the  homes  of  tuberculous  patients.  The  dispensaries  are  also 
given  the  important  function  of  examining  the  applicants  for  admission 
to  the  Sanitarium.  The  Bureau  of  Special  Relief  is  an  important  part 
of  the  Dispensary  Department. 

The  educational  work  of  the  Sanitarium,  by  means  of  literature  and 
exhibits,  is  gradually  developing  to  the  point  of  necessitating  the  organi- 
zation of  a  special  Educational  Department. 


View  of  a  Section  of  the  Chicago  Tuberculosis  Exhibit 


36 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


- 

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03 


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CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


37 


In  a  general  way  the  present  activities  of  the  Chicago  Municipal 
Tuberculosis  Sanitarium  can  be  illustrated  by  the  following  diagram: 


PRESENT  ACTIVITIES  OF 
CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


BOARD  OF  DIRECTORS 
GENERAL  OFFICE 


DJSPENSARVDEPX 


SANITARIUM 


BUREAU  or 
SPECIAL  RELIEF 


DUCATIONAlDEPT. 


II.      THE  IMPORTANT   FEATURES  OF  THE   SANITARIUM    PROPER 


Provision  for  Incip- 
ient and  Moderately 
Advanced  Cases 


The  policy  of  sanitaria  heretofore  has  been  to 
provide  chiefly  for  patients  in  incipient  stages 
of  the  disease.  A  study  of  the  tuberculosis  situ- 
ation in  any  community  will  show  that  the  tuber- 
culous patients  in  the  incipient  stages  of  the 

disease  can  secure  admission  to  a  sanitarium  with  little  difficulty,  pro- 
vided such  an  institution  is  in  existence.  The  condition  is  the  same  in 
the  case  of  the  far  advanced  tuberculous  patient  who  is  seeking  admission 
to  a  hospital  for  advanced  cases.  The  patient  in  the  moderately  advanced 
stage  of  the  disease  is  in  a  more  difficult  position  as  he  is  frequently  con- 
sidered too  advanced  for  the  sanitarium  and  too  incipient  for  the  hospital. 

To  meet  the  great  need  in  a  large  community  of  a  provision  for 
moderately  advanced  cases  of  tuberculosis,  as  well  as  for  those  cases  in 
which,  regardless  of  a  temporary  serious  condition,  the  estimate  of  the 
patient's  chances  of  improvement  can  be  made  only  after  sufficient  ob- 
servation, the  Chicago  Municipal  Tuberculosis  Sanitarium  arranged,  in 
addition  to  650  beds  in  open  air  cottages  for  incipient  cases,  an  Infirmary 
with  a  capacity  of  about  300  beds  for  the  accommodation  of  such  cases 
as  are  either  more  or  less  advanced  or  in  which  the  prospects  are 


38  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

uncertain  because  of  temporary  complications  or  grave  symptoms.  The 
Infirmary  will  be  used  for  patients  whose  condition  requires  absolute 
rest. 

In  a  general  way  the  primary  provision  of  the  Sanitarium  will  be 
for  incipient  and  moderately  advanced  cases.  In  creating  the  present 
facilities,  the  Board  of  Directors  had  in  mind  a  future  material  extension 
of  the  provision  for  the  far  advanced  cases  of  the  disease. 


In  planning  the  medical  and  laboratory  facilities 

Comprehensive  of  the  Sanitarium,  full  recognition  was  given  to 

Medical  and  Labo-  the  importance  of :  First,  the  study  of  individual 
ratory  Facilities  for  cases  of  tuberculosis  with  the  aid  of  all  the 
the  Study  and  Treat-  medical  and  laboratory  methods  in  use  in  mod- 
ment  of  Cases  ern  general  hospitals  and,  second,  the  efficient 

treatment  not  only  of  the  tuberculous  disease, 

per  se,  in  each  individual  case,  but  also  of  all  the  co-existing  and  com- 
plicating conditions.  The  adequacy  and  efficiency  of  the  medical  and 
laboratory  arrangements  for  the  study  and  treatment  of  individual  cases 
in  a  sanatorium  is  an  index  of  its  general  efficiency,  and  this  idea  in- 
spired the  planning  of  the  comprehensive  medical  and  laboratory  facilities 
of  the  Chicago  Institution. 

The  facilities,  as  provided,  are  as  follows: 

(a)  The  Main  Administration  Building  contains  the  following  pro- 
visions for  the  ambulant  patients   (ultimate  number,  650)  : 

Office  of  the  Medical  Director;  Medical  Record  room;  a  suite  of  three 
Examining  rooms  with  two  dressing  rooms;  a  modern  equipped  Laboratory 
(four  rooms);  X-Ray  Department;  Nose  and  Throat  room;  Minor  Surgery 
room;  Dental  room;  Pharmacy;  Office  of  Superintendent  of  Nurses;  Nurses' 
Conference  room. 

(b)  Each   of  the   two  Unit  Administration  Buildings,   one   of 
which  is  centrally  located  in  the  south  group  of  open  air  cottages  (ulti- 
mately 14  cottages  for  325  women  patients)   and  another  in  the  north 
group  of  cottages   (same  capacity)    for  male  patients,  contains  special 
examining  and  treatment  rooms  and  also  a  small  laboratory  for  routine 
examinations.    In  all  there  are  five  such  rooms  in  each  Unit  Administra- 
tion building,  namely : 

Examining  room;  Nose  and  Throat  room;  Laboratory;  Nurses'  room; 
Drug  and  Supply  room. 

(c)  The  Administration  Building  of  the  Infirmary  includes  the 
following  provisions : 

Office  of  Senior  Physician;  Examining  room;  Nose  and  Throat  Room; 
Medical  Record  room;  Orthopedic  room;  Operating  room  (suite  of  five  rooms); 
Routine  Laboratory;  X-Ray  room;  Head  Nurses'  room;  Drug  and  Supply 
room. 

Each  Infirmary  wing  (125  beds)  has  five  Nurses'  offices. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


39 


Men's  Grounds 


Women's  Grounds 


Separate  Grounds 
for  Male  and  Female 
Patients 


The  plan  of  the  daily  routine  of  patients  at  the 
Institution  includes  provision  for  social  recrea- 
tion in  the  evening  hours  in  the  Assembly  Rooms, 
to  which  both  sexes  are  admitted.  This  has  also 
reference  to  religious  services  and  such  special 

occasions  as  celebration  of  National  holidays,  etc. 

Outside  of  the  gatherings  above  mentioned  the  men  and  women 

patients  at  the  Institution  follow  the  daily  routine  on  their  own  grounds. 

The  grounds  of  the  Institution,  as  previously  stated,  are  equally  divided 

into  two  sections,  one  for  men  and  one  for  women. 

With  the  ultimate  capacity  of  950  beds  in  the  San- 
itarium (650  ambulant  cases  in  the  open  air  cot- 
tages and  300  bed  cases  in  the  Infirmary),  it  is 
planned  to  conduct,  in  ambulant  cases,  all  initial, 
monthly  and  before-discharge  examinations  in 

the  examining  rooms  of  the  Main  Administration  Building,  under  the 

direct  supervision  of  the  Medical  Director  and  his  Associate.     For  this 

purpose  a  suite  of  five  rooms  (3  examining  and  2  dressing  rooms)  were 


The  Plan  of  the 
Medical  Supervision 
of  Cases 


40  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

included  in  the  medical  section  of  the  Main  Administration  Building. 
Other  examinations  or  routine  treatments  necessitated  by  inter-current 
affections,  complications,  etc.,  will  be  conducted  in  the  examining  rooms 
of  the  Unit  Administration  Buildings  by  the  Senior  and  Junior  Physi- 
cians. The  Infirmary  patients  will  be  examined  in  their  rooms  in  the 
Infirmary.  Convalescent  Infirmary  patients,  if  in  condition,  will  be  exam- 
ined in  the  examining  rooms  of  the  Infirmary  Administration  Building. 

The  central  laboratory  in  the  Main  Administra- 

The  Laboratory  tion  Building  consists  of  four  rooms;  the  main 

Study  of  Cases  laboratory  room,  under  the  direct  supervision  of 

the   Chief   Bacteriologist,   with   space    for   four 

men;  adjoining  this,  the  private  laboratory  of  the  Chief  Bacteriologist; 
the  laboratory  work  room  with  space  equal  to  the  main  laboratory  and 
the  animal  experimentation  room. 

It  is  planned  that  all  work  requiring  the  direct  supervision  of  the  Chief 
Bacteriologist  should  be  done  in  the  central  laboratory. 

The  routine  examinations  of  sputum,  urine  and  blood  will  be  made, 
as  previously  stated,  in  the  auxiliary  laboratories;  for  the  ambulant  cases 
— in  the  Unit  Administration  Buildings ;  for  the  Infirmary  cases — in  the 
Infirmary  Administration  Building. 

The  Infirmary  Administration  Building  includes 

Post-Mortem  a  modern  autopsy  room  for  post-mortem  study  of 

Study  of  Cases  such  cases  in  which  the  consent  of  the  family  can 

be  obtained.    This  work  will  be  in  charge  of  the 
Laboratory  Director. 

Recognizing  the  importance  of  X-Ray  study  of 

The  X-Ray  Study  tuberculosis  cases,  the  following  provision  has 
of  Cases  been  made  for  this  work : 

The  X-Ray  department  of  the  Main  Admin- 
istration Building  consists  of  three  rooms  with  all  the  necessary  equip- 
ment for  X-Ray  and  fluoroscopic  study  of  cases. 

The  Infirmary  Administration  Building  has  its  own  X-Ray  and 
fluoroscopic  room  for  the  study  of  Infirmary  cases. 

The  development  of  all  X-Ray  plates  will  be  done  in  the  dark  room 
included  in  the  X-Ray  Department  of  the  Main  Administration  Building. 

The  Main  Administration  Building  has  a  well 

Study  and  Treat-  equipped  nose  and  throat  department  in  which 

ment  of  Nose  and  will  be  conducted  the  examinations  of  nose  and 

Throat  Conditions         throat  of  all  patients  on  admission  and  before 

discharge  and  also  such  examinations  as  may  be 

indicated  during  the  patient's  stay  at  the  Institution.  All  operative  work 
for  the  correction  of  nasal  and  throat  conditions  will  be  done  here  under 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  41 

the  direction  of  the  Associate  Medical  Director.  Routine  treatments  of 
nose  and  throat  in  ambulant  cases  will  be  given  in  the  nose  and  throat 
rooms  in  the  Unit  Administration  Buildings. 

The  Infirmary  has  its  own  nose  and  throat  department  located  in  its 
Administration  Building. 

The  importance  of  oral  hygiene  in  the  treatment 

Treatment  of  of  tuberculous  patients  was  recognized  in  arrang- 

Dental  Conditions          ing  a  dental  department  in  the  Main  Adminis- 
tration Building.    A  dentist  giving  full  time  will 
be  in  charge. 

An  Orthopedic  Department  with  all  the  neces- 

Orthopedic  sary  equipment  for  the  treatment  of  joint  and 

Department  bone  tuberculosis  was  incorporated  in  the  plans 

of  the  Infirmary  Administration  Building.  A 
section  of  each  Infirmary  Wing  will  be  assigned  to  this  class  of  cases. 

The  Infirmary  Administration  Building  includes 

Surgical  operating  rooms,  with  all  the  necessary  equip- 

Department  ment  for  major  and  minor  operations  required  in 

the  treatment  of  the  purely  tuberculous  or  com- 
plicating conditions.  In  addition  to  this,  a  surgical  dressing  room  was  pro- 
vided in  the  Main  Administration  Building  for  minor  surgery  that  may 
be  required  in  the  case  of  ambulant  patients. 

Of  the  ultimate  capacity  of  650  beds  for  ambu- 

Provision  for  Tuber-  lant  cases,  the  Sanitarium  will  have  from  200  to 
culous  Children  240  beds  for  children.  This  provision  is  a  com- 

bination of  a  sanitarium  arrangement  with  open 

air  school,  the  children  being  housed  in  open  air  cottages,  each  of  which 
has  a  capacity  of  25  to  30  beds.  Children  whose  condition  calls  for 
absolute  rest  will  be  treated  in  the  Infirmary. 

The  facilities  of  the  Infirmary  of  the  Sanitarium 

A  Maternity  De-  include  an  important  provision  for  tuberculous 

partment  for  Tuber-  prospective  mothers.  It  consists  of  confinement 
culous  Women  rooms  with  all  the  modern  facilities,  and  a  series 

of  adjoining  private  rooms  so  located  that  their 
number  can  be  easily  extended  to  meet  the  demands  of  the  situation. 

This  provision  is  the  first  of  its  kind  in  the  country  and  will  no  doubt 
prove  to  be  of  great  value  in  relieving  a  considerable  proportion  of  dis- 
tressing situations  in  which  the  tuberculous  mother,  the  newborn  babe, 
as  well  as  the  rest  of  the  family,  are  frequently  found  together  in  an 
environment  in  which  prevention  of  infection  is  absolutely  impossible. 


42  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

The  Nursery  is  for  the  accommodation  of  two 
Nursery  for  Infants      classes  of  infants: 

of  Tuberculous  First t  newborn  infants  from  the  Maternity 

Parents  Department  of  the  Sanitarium; 

Second,  infants  removed  from  those  home 

surroundings  in  which  prevention  of  infection  is  impossible.  The  initial 
accommodation  is  for  twenty.  The  full  consent  of  the  parents  will  be  the 
prerequisite  of  admission  to  this  department. 

A  further  extension  of  this  provision  will  be  made  as  soon  as  the 
various  phases  of  the  regime  are  formulated  in  the  course  of  actual  expe- 
rience with  this  new  work.  Undoubtedly  the  undertaking  will  prove  of 
great  value  in  meeting  one  of  the  serious  problems  of  the  tuberculosis 
situation,  viz. :  the  care  of  infants  of  tuberculous  mothers  and  education 
of  the  community  in  the  matter  of  proper  care  of  all  infants  with  poor 
resistance  who  are  in  close  contact  with  tuberculous  infection. 

To  facilitate  control  of  any  incipient  epidemic  of 

Provision  for  Isola-  contagious  disease  at  the  Institution  a  special 
tion  of  Suspicious  ward  for  each  sex  was  included  in  the  plans  of 

Cases  of  Contagious  the  Infirmary.  These  two  isolation  wards  are 
Disease  practically  separate  buildings  attached  to  the  east 

end  of  each  Infirmary  wing.    Each  isolation  ward 

contains  three  single  rooms  for  patients,  nurse's  room,  separate  bath  and 
toilet  facilities  for  patients  and  nurse,  diet  kitchen  and  special  dressing 
room  for  physicians. 

It  is  planned,  to  as  great  extent  as  possible,  to 

Open  Air  Quarters  give  employment  to  the  discharged  patients  in 
for  Ex-Patients  in  various  departments  of  the  Institution.  In  the 
Service  of  the  furtherance  of  this  policy,  open  air  sleeping  quar- 

Sanitarium  ters  were  provided  in  various  employes'  build- 

ings.   Of  the  total  housing  capacity  for  about  150 

employes,  44  beds  are  on  specially  constructed  open  air  porches.  The 
respective  number  of  these  beds  in  the  various  buildings  is  as  follows : 

Open  Air  Porch 
Total  Provision         Provision 

Nurses'  Building 74  beds  21  beds 

Women  Employes'  Quarters 39  beds  16  beds 

Male  Employes'  Quarters 23  beds  7  beds 

In  addition  to  this  special  provision  window  space  in  all  employes' 
rooms  is  large  enough  to  permit  a  practical  approach  to  open  air  sleep- 
ing, the  windows  varying  from  3  feet  by  6  feet  to  3  feet  10  inches  by 
6  feet  8  inches. 

In  the  main,  the  medical  arrangement  of  the  Chicago  Municipal 
Tuberculosis  Sanitarium  was  so  planned  as  to  render  possible : 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  43 


Administration  Building 

1.  A  thorough  study,  with  the  aid  of  all  modern  methods,  of  each 
individual  case  of  tuberculosis  admitted  to  the  Institution. 

2.  An  efficient  treatment  of  cases  of  pulmonary  tuberculosis  as  well 
as  tuberculosis  of  other  organs. 

3.  An  efficient  treatment  of  important  special  classes  of  cases,  such 
as  infants  of  tuberculous  mothers,  tuberculous  children,  maternity  cases 
among  tuberculous  women,  etc. 

The  Sanitarium,  with  its  present  provision,  is  being  launched  to  begin 
the  serious  work  of  institutional  control  of  the  important  phases  of  the 
tuberculosis  problem  in  Chicago.  The  present  comprehensive  arrange- 
ment is  offered  as  the  broad  foundation,  from  which  the  ultimate  complete 
system  of  municipal  institutional  control  of  the  disease  in  Chicago  can 
be  realized. 

DESCRIPTION  OF  THE  INDIVIDUAL  BUILDINGS 

The  Main  Administration  Buiding  is  in  the  fore- 
Administration  ground  of  the  central  group  of  Sanitarium  build- 
Building  ings.  It  is  a  two-story  brick  structure,  52  by  194 

feet. 

In  main,  this  building  contains  five  provisions:  (1)  the  central 
business  and  medical  administrative  offices  for  the  entire  Institution; 
(2)  the  examining  and  special  treatment  rooms  for  the  ambulant  group 
of  cases,  the  number  of  which  will  reach  650  with  the  completion  of 
the  Institution  (for  detailed  description  of  the  administration  of  ambu- 
lant cases,  see  page  53)  ;  (3)  the  main  laboratory ;  (4)  the  quarters  for 
certain  office  employes  and  the  medical  staff  (with  the  exception  of  that 
for  the  Infirmary)  ;  (5)  storerooms  for  all  general  supplies  with  the 
exception  of  foodstuffs,  for  which  comprehensive  storage  space  is  pro- 
vided in  the  Service  Building). 


44 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


PLAN 


'BU,  p4rf     LJ       rnJjw  Leg  i 


ADMINIJTHATIO/i     BVILDl/ia. 

CJJ 1CAQ  O-MVNI CIP1L-TVBE  CCVLO  3a  JAXITAE I V* 


Floor  Plans  of  Administration  Building 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  45 

The  provisions  included  in  the  Main  Administration  Building  are 
distributed  as  follows: 

First  floor  Two  X-Ray  rooms 

Waiting  room  Main  Laboratory 

Business  office  Chief     Bacteriologist's     Labora- 

Directors'  room  tory 

Library  Lavatories 

Pharmacy 

Office  of  Medical  Director 

Medical  Record  room  Second  floor 

Office  of  Superintendent  of  Suite  of  rooms  for  the  Medical 

Nurses  Director 

Nurses  Conference  room  Twelve  rooms  for  Resident  Phy- 

Three  Examining  rooms  (with  sicians  and  other  office  em- 
two  dressing  rooms)  ployes 

Minor  Surgery  room  Visitors'  room 

Nose  and  Throat  room  Physicians'  Library  and  Parlor 

Dental  room  Bath  rooms 

Basement 

Laboratory  Work  Room  and  Ani- 
mal Experimentation  room 
Two  Drug  and   Medical   Supply 

rooms 
(The  basement  laboratories  and 

drug  rooms  are  connected  by 

separate    stairways    with    their 

respective  departments  on  the 

first  floor) 

Medical  Record  store  room 
General  supply  receiving  room 
Nine  storage  rooms  (3,000  square 

feet  of  space) 

Two  Public  Comfort  Stations 
Transformer  room 
Janitor's  closet 

The  Main  Administration  Building  is  connected  by  a  tunnel  9  feet 
wide  with  the  Service  Building,  the  Dining  Halls,  the  Infirmary  and  the 
Power  House.  The  tunnel  extends  a  distance  of  1500  feet. 

The  large  windows  in  this  building,  4  feet  4  inches  by  6  feet,  permit 
most  thorough  ventilation. 

The  estimated  cost  of  this  building  is  $88,000. 

One  hundred  feet  east  of  the  Main  Administra- 

Service  Building  tion  Building  is  a  group  of  three  buildings  ar- 

ranged in  the  shape  of  a  cross,  in  which  the  two 

Patients'  Dining  Halls,  which  extend  east  and  west,  form  a  vertical  line 
divided  in  the  center  by  the  Service  Building  extending  north  and  south. 

The  position  of  the  above  buildings  is  as  follows:  First,  Patients' 
Dining  Hall  (for  men);  east  of  it  the  Service  Building;  east  of  the 
Service  Building,  the  Women's  Dining  Hall. 

The  Service  Building,  a  two-story  and  basement  brick  structure, 
contains  the  following  provisions :  ( 1 )  the  culinary  department  for  the 
entire  Institution,  with  all  its  auxiliary  arrangements;  (2)  the  Steward's 


46  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


Men's  Dining  Hall,  Service  Building  and  Women's  Dining  Hall 

office  and  the  housekeeping  department;  (3)  stores  for  foodstuffs  and 
supplies  for  the  culinary  department;  (4)  quarters  for  the  female  service 
employes. 

The  plan  of  food  distribution  to  the  various  departments  of  the 
Institution  is  as  follows: 

For  Ambulant  Patients.  Food  is  carried  from  the  kitchen  through 
connecting  corridors  leading  directly  to  the  two  Patients'  Dining  Halls, 
which  are  for  the  accommodation  of  the  ambulant  cases. 

For  Infirmary  Patients.  Food  is  carried  in  steam-heated  con- 
tainers, placed  in  dumb  elevators,  to  basement  of  the  Service  Building, 
then  through  the  tunnel  a  distance  of  630  feet  to  serving  pantries  in  con- 
nection with  the  two  dining  halls  of  the  Infirmary  (one  for  each  wing). 

Both  Infirmary  wings  are  provided  also  with  diet  kitchens  on  each 
floor  for  the  preparation  of  any  special  diet  required  in  certain  cases. 

The  Infirmary  Dining  Halls,  one  for  each  sex,  are  one-story  struc- 
tures attached  to  the  center  of  each  Infirmary  wing,  and  measuring  29  feet 
8  inches  by  55  feet  2  inches.  They  have  large  triple  windows  extending 
along  the  entire  west,  north  and  east  sides,  furnishing  plenty  of  light 
and  ventilation.  The  ceiling  is  12  feet  high. 

It  was  anticipated  that  out  of  150  patients  in  each  Infirmary  wing 
60  would  be  the  largest  number  that  would  be  in  a  condition  to  go  to 
the  dining  room.  This  estimate  was  made  the  basis  in  arranging  the 
capacity  of  both  dining  halls,  the  position  of  which  is  such  that  their 
capacity  can  be  very  easily  extended. 

For  Medical  Staff.  The  dining  room  for  the  medical  staff  is  con- 
nected by  a  special  serving  pantry  with  the  main  kitchen,  which  is  just 
west  of  it.  It  is  a  pleasant  room.,  17  feet  5  inches  by  22  feet,  provided 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


47 


DAiLMLNT    PLAN 


Floor  Plans  of  Service  Building  and  Dining  Halls 


48  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

with  large  French  windows  on  the  south,  west  and  east  sides,  this  insur- 
ing plenty  of  light  and  ventilation.  The  room  was  planned  to  seat  about 
30  people. 

For  Nurses.  The  Nurses'  Dining  Room  is  at  the  south  end  of 
the  Service  Building,  connected  with  the  kitchen  by  a  corridor  46  feet 
long.  It  has  its  own  serving  pantry.  The  Dining  Room,  21  feet  4  inches 
by  49  feet  10  inches,  is  exposed  to  the  west,  south  and  east  sides,  and  is 
provided  with  plenty  of  window  space.  The  room  was  planned  to  seat 
comfortably  75  people. 

For  Employes.  The  Employes'  Dining  Room  is  at  the  north 
end  of  the  Service  Building,  exposed  to  the  west,  east  and  north  sides, 
with  plenty  of  window  space  to  insure  thorough  ventilation.  This  dining 
room  is  21  feet  4  inches  by  49  feet  10  inches  and  was  planned  to  accom- 
modate in  two  sittings  all  the  service  employes  in  the  Institution. 

To  summarize  briefly  the  general  plan  of  dining  room  service  in  the 
Sanitarium : 

(1)  Food  to  all  departments,  with  the  exception  of  the  Infirmary, 
is  carried  directly  from  the  kitchen  to  the  respective  dining  halls  con- 
nected with  it;  (2)  food  to  the  Infirmary  is  carried  in  special  containers 
through  the  tunnel  to  the  Infirmary  Dining  Halls. 

The  provisions  found  on  each  floor  of  the  Service  Building  are  as 
follows  : 

First  floor  Second  floor  (Quarters  for  women 

Main  kitchen  employes) 

Dishwashing  room  Housekeeper's     suite     (2    rooms 

Chefs  refrigerators  and  bath) 

Supply  pantry  Eleven  double  rooms 

Bakery  Sitting  room 

Steward's  office  Two  open  air  sleeping  porches 

Linen  room  (16  beds) 

Housekeeper's  office  Locker  rooms 

Staff  dining  room  Linen  room 

Nurses'  dining  room  Bath  and  toilet  facilities 

Basement. 

Service  employes'  recreation  room  (separate  entrance);  Scullery;  Vege- 
table room;  three  Refrigerators;  Receiving  room  (supplies);  two  storerooms; 
Butcher  shop;  Employes'  toilet  rooms. 

The  store  space  of  the  Service  Building  is  about  2,200  square  feet. 
The  Service   Building  has   its   own   enclosed  yard,  through  which 
all  supplies  for  this  building  are  delivered  into  the  general  receiving  room. 
The  kitchen  department  of  the  Service  Building  is  fireproof. 

The  two  Patients'  Dining  Halls   (for  men  and 

Patients'  women),   one  east  and  the  other  west  of  the 

Dining  Halls  Service   Building,   are   one-story   and   basement 

structures,  connected  to  the  Service  Building  by 
enclosed  corridors. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  49 

Each  Dining  Hall  is  111  by  62  feet  and  is  provided  with  four  en- 
trances from  which  stairways  lead  down  to  patients'  cloakrooms  in  the 
basement,  which  is  well  above  the  ground,  insuring  plenty  of  light  and 
ventilation.  From  the  same  entrance  vestibules  four  stairways  lead  to 
the  Dining  Halls. 

The  Dining  Halls  are  from  13  to  17  feet  high,  the  ceiling  being 
arched,  80  feet  long  and  49  feet  wide.  They  are  provided  with  large 
windows  on  the  south  and  north  sides,  5  feet  by  7  feet  11  inches.  The 
floor  is  red  tile. 

In  arranging  the  accommodation  of  the  Dining  Halls  it  was  planned 
to  seat  the  patients  in  groups  of  eight  at  tables  placed  in  four  rows  along 
the  long  axis  of  the  Dining  Hall,  each  row  containing  8  tables.  The 
utmost  capacity  of  each  Dining  Hall  is  for  about  300  patients. 

As  in  all  other  buildings  of  the  Sanitarium,  the  Patients'  Dining 
Halls  are  devoid  of  any  ornamentation.  They  are  simple  in  design, 
attractive  in  appearance  and  provide  plenty  of  space,  light  and  air. 

The  estimated  cost  of  this  group  of  buildings  (Service  Building  and 
Dining  Halls),  is  $207,000. 

The  Infirmary  group  of  buildings  consists  of  a 

Infirmary  Group  central  Administration  Building  and  two  Infir- 

mary wings,  one  for  each  sex.     The  buildings 

are  two-story  and  basement,  of  fireproof  construction,  built  of  brick  and 
reinforced  concrete.  They  form  by  their  position  the  letter  "H,"  in  which 
the  two  hospital  wings  represent  the  vertical  lines  and  the  Administration 
Building  the  connecting  link. 

The  Infirmary  occupies  a  central  position  on  the  Sanitarium  Grounds. 
It  is  east  of  the  Women's  Dining  Hall,  the  distance  ranging  from  125 
feet  to  the  west  ends  of  the  Infirmary  wings  to  240  feet  to  the  Infirmary 
Administration  Building.  The  buildings  are  so  placed  as  to  give  the 
patients  utmost  freedom  from  any  disturbing  influences  and  to  furnish 
them  with  practically  separate  grounds. 

Two  lawns,  one  200  feet  square,  and  another  150  by  200  feet,  are 
east  and  west  of  the  Infirmary  Administration  Building,  being  accessible 
to  both  Infirmary  wings.  A  lawn  north  of  the  Men's  Infirmary  wing 
extends  along  the  entire  building  300  feet  to  the  north.  A  similar  lawn 
south  of  the  Women's  Infirmary  wing  extends  200  feet  to  the  south.  A 
wide  lawn  is  interposed  between  the  Infirmary  and  the  Power  House, 
extending  a  distance  of  700  feet. 

In  a  general  way  the  Infirmary  contains  the  following  provisions : 

(1)  Administrative  medical  offices  of  the  Infirmary;  (2)  quarters 
of  the  Infirmary  medical  staff;  (3)  examining  and  special  treatment 
rooms  for  the  Infirmary  cases,  including  the  Orthopedic  room;  (4)  rou- 
time  laboratory  of  the  Infirmary;  (5)  special  X-Ray  department;  (6) 


50  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

operating  rooms  of  the  Institution;  (7)  Maternity  department;  (8) 
Nursery;  (9)  Special  Isolation  department  in  each  Infirmary  wing; 
( 10)  74  single  rooms  for  patients,  44  double  rooms  and  16  open  air  wards, 
each  with  a  capacity  of  6  to  8  beds;  (11)  one  dining  hall  with  serving 
pantry  and  diet  kitchen  in  each  Infirmary  wing;  (12)  Mortuary  and 
Autopsy  Rooms  in  the  basement. 

The  location  and  the  arrangements  of  the  Infirmary  were  so  planned 
as  to  make  this  department  a  practically  complete  unit  in  itself  in  most 
of  its  essential  provisions.  It  has  its  own  medical  and  laboratory  facili- 
ties and  includes  all  such  additional  provisions  as  are  by  their  nature  a 
part  of  an  Infirmary:  Operating  rooms,  Orthopedic  Department,  Ma- 
ternity Department,  etc.  '  , 

The  character  of  cases  to  be  treated  in  the  Infirmary  determined  the 
type  of  the  patients'  quarters,  about  one-third  of  the  provision  consisting 
of  single  rooms  for  patients  who  are  acutely  ill,  requiring  absolute  rest, 
one-third  double  rooms,  and  one-third  six-bed  open  air  wards,  reserved 
for  convalescent  cases. 

Each  floor  in  the  Infirmary  Wings  has  its  own  diet  kitchen  for  the 
preparation  of  special  dietary  or  additions  to  the  general  diet  of  the  main 
kitchen. 

Special  utility  rooms  are  provided  on  each  floor  with  all  the  equip- 
ment necessary  in  the  handling  of  bed  cases. 

Close  supervision  of  individual  cases  is  rendered  possible  by  the 
employment  of  adequate  medical  and  nursing  service,  assisted  by  a  silent 
signal  system  connecting  all  the  patients'  quarters  with  the  nurses'  offices. 

All  patients'  rooms-  are  supplied  either  with  casement  windows  with 
transoms  above  them,  or  with  triple  hung  windows,  this  permitting  the 
transformation  of  any  room  into  practically  an  open  air  porch. 

The  open  air  wards  include:  (1)  a  sleeping  porch,  16  feet  by  32 
feet,  facing  south  and  equipped  on  that  side  with  triple-hung  sash  win- 
dows, for  use  in  case  of  stormy  weather;  (2)  locker  and  dressing  rooms, 
14  feet  4  inches  by  22  feet  3  inches,  and  (3)  toilet  and  bath  rooms  con- 
taining 1  toilet,  3  wash  basins,  1  tub  and  1  dental  lavatory. 

A  corridor,  9  feet  4  inches  wide  and  357  feet  long,  extends  along 
the  entire  length  of  each  Infirmary  Wing  to  a  large  open  air  recreation 
porch,  26  feet  6  inches  by  73  feet  3  inches,  at  the  east  end  of  each  build- 
ing. The  four  recreation  porches  are  open  on  the  east  and  south  sides 
with  canvas  curtains  provided  for  use  in  stormy  weather.  The  porches 
are  for  the  accommodation  during  the  day  of  patients  in  the  single  and 
double  rooms,  whose  condition  permits  a  change  for  the  .day,  or  part 
of  the  day,  from  the  monotony  of  a  private  room  to  the  diversion  afforded 
by  the  companionship  of  other  patients. 


CHICAGO  MUNICIPAL  -TUBERCULOSIS  SANITARIUM 


51 


The  estimated  cost  of  the  Infirmary  Group  is  $599,650. 
The  individual  provisions  are  distributed  as  follows : 


Infirmary  Administration  Building 

First  Floor 

Office  of  Senior  Physician;  Examining  room,  with  adjoining  dressing 
room;  Nose  and  Throat  room;  Laboratory;  Drug  room;  Head  Nurse's  Office; 
Medical  Record  room;  X-Ray  room;  Operating  Department  (suite  of  six 
rooms);  Orthopedic  room;  Surgical  Dressing  room;  Linen  room;  Toilet  room. 

Second  Floor 

Associate  Medical  Director's  Suite  (five  rooms  with  bath);  six  single 
bedrooms;  General  Living  room;  Linen  room;  Bath  and  Toilet  rooms. 

Basement 

Mortuary  and  Autopsy  rooms;  Disinfecting  room;  Sputum  room;  Machine 
room;  Transformer  room;  Supply  Receiving  room;  Public  Comfort  Stations; 
Employes'  toilet  rooms. 


•    INFIRMARY  CROUP 

CHICAGO  MUNICIPAL  TUDLKCULQJI/.ANITAK1UM. 


DOARD    -  Of    -   D1KLCTORJ 
GLOKGL  D.  YOU/tG  M.D.  -  WA^WILDOLDT. 


riR/r  HOOK  PLAA  - 
Infirmary  First  Floor  Plan 


52 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


INFIRMARY  CROUP 

CHICAGO  MUNICIPAL  TUrttCULQ/JJVANITAKIUA 


DOARD  -  O,        DlttCTOK/ 
THLODORL    D  OSOU  MD.PtL/ 
GLOtGL   D.  YOUAG  MD.  -  W.  A  W1LDOLDT 


COMMITTU  -  OK   •  PLAAJ 
THLODOIL  D  J20J  MD.  CrtAlRJAWl 


ADM1A1JTKAT10N  DU1LDIAC 


PLAA  • 

Infirmary  Second  Floor  Plan 


First  floor 

Dining  room  and  Serving  Pantry 

Diet  Kitchen 

Two  Nurses'  Offices 

Two  Utility  rooms 

Two   Linen  rooms 

Four   Open  Air  Wards    (6  beds 

each)    with    locker    and    toilet 

rooms 
Eight    Patients'    Double    rooms, 

12   feet   6   inches   by   13   feet   4 

inches 
Eighteen  Patients'  Single  rooms, 

8    feet   6   inches   by    14   feet    4 

inches 
Sun  room 
Recreation  porch 


Men's  Infirmary 

Second  floor 

Two  Nurses'  offices 

Diet  Kitchen 

Two  Utility  rooms 

Two  Linen  rooms 

Sun  room 

Recreation  Porch 

Bath  and  Toilet  rooms 

Four   Open  Air   Wards    (6  beds 

each,   with    locker    and     toilet 

rooms) 
Fifteen  Patients'  Double  rooms, 

12   feet   6   inches   by   14  feet   4 

inches 
Seventeen  Patients'  Single  rooms 

8    feet   6    inches   by   14    feet   4 

inches 


Isolation  ward 

Three  single  rooms,  nurse's  room 
with  bath,  diet  kitchen,  pa- 
tients' bath  room 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


53 


Women's  Infirmary 


First  floor 

Dining  room  and  Serving  Pantry 

Diet  Kitchen 

Two  Nurses'  offices 

Two  Utility  rooms 

Two  Linen  rooms 

Four  Open  Air  Wards  (6  beds 
each,  with  locker  and  toilet 
rooms) 

Six  Patients'  Double  rooms 

Sixteen  Patients'  Single  rooms 

Maternity  Department 

Nursery,  with  diet  kitchen  at- 
tached 

Sun  room 

Recreation  Porch 


Second  floor 

Two  Nurses'  offices 

Diet  Kitchen 

Two  Utility  rooms 

Two  Linen  rooms 

Sun  rooms 

Recreation  Porch 

Bath  and  Toilet  rooms 

Four  Open  Air  Wards  (6  beds 
each,  with  locker  and  toilet 
rooms) 

Fifteen  Patients'  Double  rooms 

Seventeen  Patients'  Single  rooms 
Isolation  Ward 

Three  single  rooms,  nurse's  room 
with  bath,  diet  kitchen,  pa- 
tients' bath  room 


Basement  Plan,  Infirmary   Administration  Building  and  Part  of 
Infirmary  Wings 


Quarters  and 
Grounds  for 
Ambulant  Cases 


Some  of  the  important  features  of  the  general 
arrangement  of  quarters  and  grounds  for  ambu- 
lant patients  are  as  follows : 

Grounds  cmd  Grouping  of  Cottages.   The  cot- 
tages for  the  ambulant  women  patients,  including 

children  of  the  same  sex,  occupy  an  area  of  about  15  acres  south  of  the 
central  group  of  Administration  buildings.  Those  for  the  men  and 
boys  are  north  of  the  same  group  of  buildings,  covering  an  area  of  about 
13  acres.  A  lawn  from  165  to  400  feet  wide  is  interposed  between  the 
central  group  of  Administration  buildings  and  the  group  of  cottages  on 
either  side.  The  distance  from  the  Dining  Halls  to  the  cottages  for  each 
respective  sex  varies  from  400  feet  to  1,200  feet.  The  assignment  of 
patients  to  cottages  situated  at  various  distances  from  the  Dining  Hall 
will  be  governed  by  the  general  condition  of  patients. 


o 
O 

£> 

03 

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Ifl 

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CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  55 

The  cottages  for  each  sex  are  grouped  in  rows  of  two  to  four  around 
a  central  Unit  Administration  Building.  All  cottages  face  southeast. 
This  position  gives  the  patients  the  maximum  amount  of  sunlight  and 
protects  them  from  the  hot  afternoon  sun  in  summer  and  the  prevailing 
northwest  winds  in  winter.  The  rows  of  cottages  are  separated  by  lawns 
about  70  feet  wide,  with  the  distance  between  the  ends  of  the  cottages 
averaging  100  feet. 

A  system  of  intersecting  asphalt  macadam  walks  and  drives  con- 
nects all  cottages  and  the  central  group  of  Administration  buildings. 

The  four  cottages  for  girls  and  the  same  number  for  boys  are 
grouped  together  at  the  east  end  of  the  grounds  reserved  for  each  sex. 
(The  Block  plan  on  page  19  indicates  the  position  of  buildings  for  the 
ambulant  group  of  patients.) 

The  entire  grounds  occupied  by  the  south  and  north  groups  of  cot- 
tages were  transformed  into  lawns  with  shrubs  and  perennial  plants  clus- 
tered around  the  individual  buildings. 

A  lawn  from  335  to  535  feet  wide  south  of  the  group  of  cottages 
for  women  and  from  370  to  570  feet  wide  north  of  the  group  of  cottages 
for  men  is  reserved  for  separate  recreation  grounds  for  each  sex. 

The  open  air  cottages  for  ambulant  patients  are 

Cottages  one-story  buildings  of  frame  construction  with 

for  Adults  stucco  exterior.     The  cottages  consist  of  a  cen- 

tral enclosed  portion  with  two  open  porches  on 

each  side.  The  central  portion  includes  a  living  room,  the  front  of  which 
projects  9  feet  beyond  the  two  adjoining  porches,  and  a  rear  annex  con- 
taining the  dressing  rooms,  bath  and  toilet  facilities.  This  part  of  the 
building  rests  on  concrete  posts  with  brick  walls  interposed  between  them. 
A  basement,  19  feet  2  inches  long  by  28  feet  8  inches  wide,  in  the  rear 
of  this  portion  of  the  building  is  for  the  transmission  of  service  pipes 
from  the  conduits  extending  from  the  power  house.  The  porches  rest 
on  concrete  posts. 

The  open  air  cottages  of  the  Sanitarium  were  modeled  after  the 
lean-tos  of  the  Loomis  Sanitarium  at  Liberty,  New  York,  with  all  such 
modifications  as  were  incorporated  in  the  course  of  construction  of  va- 
rious sanitaria  in  this  country,  with  the  addition  of  important  changes 
developed  in  building  the  cottages  of  the  Edward  Sanatorium  at  Naper- 
vflle.  Illinois.  Opon  air  cottages  of  various  types  were  thoroughly  studied 
and  the  final  plans  adopted  by  the  Chicago  Institution  were  the  result 
of  incorporation  of  all  desirable  features,  modification  and  elimination 
of  various  details  and  addition  of  such  arrangements  as  seemed  desirable 
from  the  standpoint  of  the  comfort  and  right  care  of  patients. 

The  porches,  63  feet  long  by  18  feet  wide,  contain  the  following 
distinctive  features: 


56  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


Type  of  Adult  Patients'  Cottage 

(1)  The  front  is  open,  with  the  exception  of  a  solid  railing  two 
feet  high  and  a  continuous  row  of  transoms,  intended  for  ventilation 
in  stormy  weather,  when  the  five-foot  open  space  extending  from  the 
railing  to  the  transoms  will  be  closed  by  means  of  canvas  curtains. 

(2)  The  end  wall  of  each  porch  has  three  windows  toward  the  rear 
and  a  large  sliding  door  in  the  front,  which  when  open  adds  materially 
to  the  ventilation. 

(3)  The  rear  wall  of  the  porch  has  a  row  of  thirteen  windows, 
which,  in  groups  of  three,  are  placed  4  feet  9  inches  above  the  floor. 

(4)  Additional  ventilation  is  provided  by  means  of  two  ventilators 
in  the  roof  over  the  porch. 

With  the  bed  placed  against  the  rear  wall  of  the  porch,  there  is  a 
space  of  three  feet  between  the  beds,  and  an  area  eleven  feet  wide  extend- 
ing the  length  of  the  entire  porch  reserved  for  the  reclining  chairs  used 
by  the  patients. 

The  living  room  is  18  feet  by  22  feet  6  inches,  with  the  ceiling  13 
feet  5  inches  above  the  floor.  It  is  steam  heated  and  has  an  open  fire- 
place, which  materially  adds  to  its  attractiveness.  From  six  to  eight 
large  casement  windows  in  the  front,  with  transoms  above  them  and 
two  high  double  sash  windows  in  the  rear,  furnish  the  necessary  light 
and  ventilation.  Two  ventilators  are  included  in  the  ceiling  of  the  room. 
Two  double  glass  doors  lead  to  the  open  air  porches,  and  two  single 
doors  connect  with  an  enclosed  vestibule  placed  between  the  living  room 
and  the  rear  annex.  The  living  room  includes  a  bookcase  built  into 
the  rear  wall  on  one  side  of  the  fireplace,  and  a  sink  on  the  other  side 
for  the  washing  of  glasses  and  dishes  used  for  any  special  diet  prescribed 
between  meals. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


57 


In  the  rear  of  the  living  room  are  two  spacious  closets. 

The  annex  is  31  feet  wide  by  34  feet  deep  and  is  divided  equally  into 
two  sections,  one  for  each  porch.  Each  section  contains  the  following 
arrangements  for  the  ten  patients  occupying  the  adjoining  porch: 

Ten  Lockers 

Five  Wash  Bowls 

One  Dental  Lavatory 

Two  Toilets 

One  Bath  Tub 

One  Shower 

One  Janitor's  Sink 

The  distinctive  features  of  this  part  of  the  building  are  as  follows : 

( 1 )  Each  locker,  3  feet  by  3  feet  9  inches,  is  provided  with  a  chest 
of  three  drawers  placed  2  feet  6  inches  above  the  floor,  with  space  under- 
neath reserved  for  trunks.     A  space,  1  foot  9  inches  by  3  feet,  in  the 
front  of  the  locker  permits  privacy  in  dressing  and  undressing.     The 
door  opening  into  the  locker  has  a  2-foot  square  wire  mesh  window  for 
the  purpose  of  ventilation.     Similar  wire  mesh  openings  are  in  the  top 
of  each  locker,  which  extends  to  about  2  feet  below  the  ceiling  of  the 
dressing  room. 

(2)  Eight  of  the  ten  lockers  in  each  dressing  room  are  placed 
against  the  central  wall,  thus  obviating  the  palpable  defect  in  some  of 
the  types  of  open  air  cottages  where  the  lockers  are  arranged  against 
the  outside  wall,  obstructing  the  ventilation  of  the  dressing  room. 

The  outside  wall  of  the  dressing  room  in  the  cottages  of  the  Chicago 
Institution  contains  two  casement  and  two  double  sash  windows,  which 
furnish  plenty  of  light  and  ventilation. 


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Floor  Plan  of  Adult  Patients'  Cottage 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


Type  of  Children's  Cottage 

(3)  Five  wash  basins  were  placed  in  each  dressing  room,  one  to  be 
assigned  to  each  two  patients,  who  will  be  held  responsible  for  its  sanitary 
condition. 

(4)  The  dental  lavatories  are  of  large  size,  17  inches  by  17  inches, 
and  11  inches  deep.     This  type  was  selected  in  order  to  obviate  the  un- 
sanitary condition  unavoidable  around  the  common  diminutive  type  of 
dental  lavatories. 

(5)  The  dressing  room  contains  9  feet  by  19  feet  of  free  space, 
which  is  larger  than  the  space  allowed  in  the  ordinary  type  of  cottage. 

The  estimated  cost  of  each  cottage  is  $14,380. 

The  open  air  cottages  for  children  are  of  frame 

Cottages  for  construction  with  stucco  exterior.     Each  cottage 

Children  consists  of  one-story  buildings,  connected  by  a 

sleeping  porch  with  an  open  terrace  in  front  of 

it.  Each  of  these  end  buildings  rests  on  concrete  posts  with  brick  walls 
interposed  between  them.  They  project  10  feet  beyond  the  north  wall 
of  the  sleeping  porch  and  contain  in  the  rear  a  basement,  9  feet  10  inches 
long  by  22  feet  5  inches  wide,  for  the  transmission  of  service  pipes  from 
the  conduits  extending  from  the  Power  House.  The  porch  rests  on  con- 
crete posts. 

The  cottages  for  children  are  of  the  lean-to  type  materially  modified 
to  meet  the  special  needs  of  sanitarium  care  of  children. 

As  the  experience  of  sanitarium  builders  up  to  the  present  date  has 
been  meager  in  the  matter  of  construction  of  open  air  buildings  specially 
designed  for  children,  it  became  necessary  to  improvise  a  number  of 
arrangements  essential  to  buildings  of  this  kind. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


59 


The  important  features  of  the  Children's  Cottage  at  the  Chicago 
Municipal  Tuberculosis  Sanitarium  are  as  follows : 

(1)  The  open  air  porch,  which  serves  as  sleeping  quarters,  is  cen- 
trally located,  connecting  the  two  end  buildings.     It  is  29  feet  9  inches 
long  and  80  feet  6  inches  wide,  giving  sufficient  space  for  twenty-five 
or  more  beds.     The  north,  west  and  east  sides  of  the  porch  are  enclosed. 
The  south  side  is  open,  having  been  treated  in  the  same  way  as  the  cor- 
responding side  in  the  adult  cottages,  with  a  railing  extending  2  feet 
3  inches  above  the  floor,  a  continuous  row  of  transoms  under  the  eaves 
and  an  open  space  4  feet  6  inches  wide,  by  78  feet  3  inches  high,  along  the 
entire  length  of  the  porch,  which  can  be  closed  with  canvas  curtains  in  case 
of  inclement  weather.     In  front  of  the  porch,  along  its  entire  length,  is 
an  open  terrace  2  feet  3  inches  above  the  ground,  which  was  planned 
for  outdoor  rest  of  children  in  favorable  weather. 

(2)  The  enclosed  east  end  of  the  building  contains:     (a)  an  office, 
10  feet  by  15  feet  3  inches,  with  a  window  overlooking  the  entire  porch, 
this  facilitating  the  supervision  essential  in  the  case  of  children;  (b)  an 
emergency  hospital  room,   12  feet  9  inches  by   15   feet  7  inches   (with 
bath  and  toilet),  for  temporary  isolation  of  children  who  may  become 
acutely  ill  at  night;  (c)  a  linen  and  supply  room,  7  feet  7  inches. by  12 
feet  9  inches;  (d)  a  spacious  dressing  room,  15  feet  by  20  feet,  which 
contains  13  lockers,  3  wash  bowls  and  a  dental  lavatory.    The  bath  room, 
8  feet  1  inch  by  18  feet  5  inches,  includes  one  bath  tub,  one  shower,  three 
toilets  and  a  janitor's  closet. 

(3)  The  enclosed  west  end  of  the  building  contains  a  large  school 
and  assembly  room,  23  feet  1  inch  by  23  feet  7  inches,  and  in  the  rear 
of  it  locker,  bath  and  toilet  rooms  for  twelve  children.     The  school  and 


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60 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


assembly  room,  the  nurse's  office  and  the  emergency  hospital  room  are 
furnished  with  casement  windows,  giving  plenty  of  light  and  ventila- 
tion. The  bath  and  locker  rooms  on  each  side  have  9  two-sash  windows. 

Additional  ventilation  is  supplied  by  three  ventilators  in  the  roof  of 
the  porch  and  one  in  each  end  building. 

The  estimated  cost  of  each  Children's  Cottage  is  $15,550. 

It  is  planned  to  use  the  Children's  Cottages  for  the  type  of  children 
in  which  sanitarium  regime  is  consistent  with  a  properly  arranged  school 
curriculum. 

In  the  matter  of  provision  of  school  teachers  the  Sanitarium  will 
have  the  co-operation  of  the  Board  of  Education. 

On  the  day  of  opening  of  the  Institution  there  will  be  four  cottages, 
with  a  total  capacity  of  50  to  60  beds  for  girls  and  the  same  number  for 
boys.  During  the  coming  year  four  more  cottages  will  be  constructed. 

All  children  acutely  ill  will  be  taken  care  of  in  the  Infirmary. 

The  cottages  for  children  are  grouped  separately  from  those  of 
adults  and  have  their  own  recreation  grounds. 

The  Sanitarium  includes  two  Unit  Administra- 

Unit  Administra-  tion  Buildings,  each  occupying  a  central  posi- 

tion Buildings  tion  in  one  of  the  two  groups  of  open  air  cot- 

tages. These  buildings  were  provided  to  facili- 
tate: (1)  close  supervision  of  the  regime  of  ambulant  cases;  (2)  ad- 
ministration of  special  routine  treatments  necessary  in  certain  cases; 
(3)  serving  of  special  diets,  and  (4)  storage  and  distribution  of  drugs 


Unit  Administration  Building 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


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and  medical  supplies  for  this  part  of  the  Institution. 

.The  Unit  Administration  Buildings  are  one-story  brick  structures, 
containing  the  following  provisions : 

Office  of  Head  Nurse  Sputum  Incinerator  room 

Drug  room  Linen  room 

Examining  room  Diet  Kitchen  (with  refrigerator  and 

Dressing  room  pantry) 

Laboratory  Lavatories 

Nose  and  Throat  room  Waiting  room 

The  estimated  cost  of  each  Unit  Administration  Building  is  $16,440. 
The  Nurses'  Home  is  situated  in  the  women's 

The  Nurses'  Home  section  of  the  grounds,  sufficiently  removed 
from  the  patients'  cottages  to  insure  privacy.  It 

is  a  "T"  shaped  two-story  and  basement  brick  building,  so  placed  as  to 
furnish  the  maximum  of  daily  sunshine  to  the  individual  rooms.  The 
front  part  of  the  building  faces  southwest,  the  rear  extension  southeast. 

The  building  is  for  the  accommodation  of  about  70  nurses,  the  esti- 
mated cost  of  construction  being  $88,600. 

Considering  the  character  of  work  of  nurses  in  a  tuberculosis  insti- 
tution, as  well  as  the  great  need  of  complete  relaxation  following  a 
day's  hard  work,  a  number  of  features  were  incorporated  in  this  build- 
ing to  afford  the  nurses  the  average  comforts  of  a  home,  combined  with 
provisions  essential  to  recuperation  and  maintenance  of  health. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


||     || 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


Nurses'  Home 

Some  of  the  important  features  of  the  Nurses'  Home  are  as  follows: 

(1)  Of  the  total  number  of  20  double  and   16  single  bedrooms, 
14  double  and  12  single  rooms  face  either  southeast  or  southwest  and 
only  4  single  and  6  double  rooms  northwest.     Every  room  has  running 
water.     Large  windows  furnish  adequate  ventilation. 

(2)  To  render  feasible  the  employment  of  cured  patients  as  pupil 
nurses,  three  sleeping  porches  were  provided  with  a  capacity  of  18  beds. 
Two  open  porches  were  provided  for  day  recreation. 

(3)  A  general  assembly  room,  23  feet  4  inches  by  44  feet  4  inches, 
with  French  windows,  and  a  reception  room,  19  feet  2  inches  by  15  feet, 
are  a  feature  of  the  Home. 

(4)  A  Utility  Room,   15   feet  by   18   feet,  with  all  the  necessary 
facilities,  was  incorporated  to  give  the  nurses  quarters  for  such  work 
as  sewing,  mending,  ironing  and  similar  work  essential  to  women. 

(5)  The  Home  includes  a  small  pantry  and  diet  kitchen  for  the 
use  of  nurses. 

(6)  The  building  is  provided  with  11  baths  and  showers  and  16 
toilets. 

The  Nurses'  Home  has  its  own  recreation  grounds. 

The  Power  House  and  Laundry  Building,  a  fire- 

Power  House  proof  brick  structure,  is  far  removed  from  all 

and  Laundry  other  buildings  of  the  Sanitarium.  It  is  at  the 

extreme  east  end  of  the  central  group  of  build- 


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CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


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ings  which  divide  the  grounds  into  the  south  and  the  north  sections. 

The  building,  with  its  tower  rising  to  a  height  of  120  feet,  stands 
out  prominently  among  all  other  buildings  and  can  be  seen  at  a  consid- 
erable distance  on  approaching  the  Institution. 

The  estimated  cost  of  the  building,  including  all  the  mechanical 
equipment,  is  $164,000. 

The  Boiler  House  section  is  a  one-story  structure  with  its  floor  line 
7  feet  below  grade.  The  roof,  as  on  all  other  buildings  of  the  central 
group,  is  of  red  tile  with  a  skylight  providing  additional  light  and  ven- 
tilation. This  in  addition  to  eight  windows,  5  feet  by  12  feet  each.  The 
Boiler  House  contains  the  following  rooms  and  equipment : 


Boiler  House  with  3  boilers  (2 
chain  grate  stokers  and  1  hand 
fired  furnace) 

Coal  Storage  room 

Ash  Storage 

Incinerator  room 


Dressing  and  Locker  room  for 
male  employes  of  the  Power 
House  and  Laundry 

Toilet  and  Shower  room  containing 

1  shower 

2  toilets 

3  wash  bowls 

The  boiler  room  is  at  the  extreme  end  of  the  tunnel  which  connects 

all  the  central  buildings.  A  passageway  connects  the  boiler  room  with 
the  machine  room  in  the  basement  of  the  laundry  section  of  the  building. 
The  Tower,  which  is  the  central  portion  of  the  Power  House  and 
Laundry  Building,  is  a  brick  structure,  33  by  33  feet.  The  first  floor 
contains  the  Chief  Engineer's  office,  bedroom  and  bath  and  toilet  room. 
The  second  and  third  floors  contain,  each,  three  bedrooms  and  bath  and 
toilet  room. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


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VIEW   FROM   NORTHWEST 

POWER   HOUSE 

CHICAGO  MUNICIPAL 

TUBERC  ULQS1S  -SAMTAR1 UM 


Power  House  and  Laundry 


In  the  upper  portion  of  the  Tower  is  a  steel  water  tank  of  60,000 
gallons  capacity.  This  arrangement  was  necessary  to  provide  a  reserve 
storage  supply  and  adequate  pressure  for  fire  protection. 

The  Laundry  Section  is  a  two-story  and  basement  structure,  con- 
taining the  following  provisions : 


First  floor 

The  main  laundry  of  the  Institu- 
tion, fully  equipped  to  do  all 
laundry  work  for  1,200  people 
and  containing  the  following 
provisions: 

Receiving  room,  with  large  ster- 
ilizing apparatus  connecting 
through  wall  to  wash  room. 

Wash  room,  containing  5  wash- 
ers, 2  extractors,  soap  tanks, 
starch  cooker,  collar  and  cuff 
starcher,  etc. 

Dry  room  and  Ironing  room,  con- 
taining large  dry  room,  drying 
tumbler,  ^  mangle,  cuff  press, 
combination  ironer,  sleeve 
ironer,  band  ironer,  2  body 
ironers,  6  ironing  boards  with 
electric  irons,  finishing  table 
with  seam  dampener,  shaper, 
edger,  etc.,  and  all  other  ne- 
cessary equipment. 

Sorting  and  Delivery  room. 


Basement 

Auxiliary  dynamo  of  full  capac- 
ity to  provide  electric  current 
in  case  of  temporary  suspen- 
sion of  the  current  supplied  by 
the  Sanitary  District. 

Service  pumps 

Hot  water  tanks 

Refrigeration  plant  (CO2)  with 
service  to  Infirmary,  Service 
Building,  Main  and  Unit  Ad- 
ministration Buildings 

Ice  making  machine 

Vacuum  exhaust  pumps 

Electric  motors  for  tool  machin- 
ery 
Second  floor 

Living  room 

8  double  bed  rooms 

Sleeping  porch  for  5  beds  with 
locker  room  adjoining. 

Linen  room 

Bath  and  toilet  room  containing 
4  wash  bowls,  2  showers,  2  tubs 
and  5  toilets 


GO  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

The  Transformer  Station  is  situated  50  feet  east 

Transformer  of  the  Power  House.    It  is  a  one-story  fireproof 

Station  brick  structure,  20  feet  2  inches  by  28  feet  2 

inches,  containing  9  transformers  for  the  reduc- 
tion of   12,000-volt  current  received  from  the  Sanitary  District,  which 
supplies  all  the  electric  power  and  light  current  needed  in  the  Institution. 
The  estimated  cost  of  the  Transformer  Station  is  $20,000. 

The    extreme    east    section    of    the    Sanitarium 
Farm  Buildings  Grounds  is  reserved  for  the  farm  buildings  and 

garage. 

The  farm  house  is  a  one-story  and  basement  brick  structure,  33 
feet  by  45  feet  6  inches,  containing  5  rooms  and  bath,  with  a  laundry 
room  in  the  basement. 

The  garage  is  a  one-story  brick  building,  46^  feet  by  73  feet,  for 
the  accommodation  of  6  to  8  automobiles  and  motor  trucks.  It  includes 
an  office,  store  room,  work  room  and  lavatory. 

The  barn  is  a  one-story  brick  structure,  27  feet  by  103  feet,  which 
includes  the  following  provisions : 

Store     room     for     farming     imple- 
ments 

Room  for  vehicles  and  trucks 
Hay  Loft 
Stable 
Harness  room. 

The  estimated  cost  of  farm  house,  barn  and  garage  is  $35,400. 

The  Gate  Lodge  was  placed  at  the  main  entrance 

Gate  Lodge  to  the  Sanitarium  Grounds  for  the  purpose  of 

direction  of  vehicles  and  pedestrians  entering  the 

Institution.  It  is  a  one-story  brick  structure,  containing  an  office,  bed- 
room, bath  and  store  room. 

The  estimated  cost  of  the  Gate  Lodge  is  $3,500. 

A  simple  wire  fence  with  iron  posts  surrounds 

Fence  the  Sanitarium  Grounds  with  an  ornamental  iron 

fence  and  gate  at  the  main  entrance.     Another 

iron  gate  is  found  at  the  northeast  corner  of  the  grounds  for  the  accom- 
modation of  heavy  traffic. 

The  Tunnel  is  one  of  the  distinctive  features  of 

The  Tunnel  the  Institution.     It  extends  from  the  Main  Ad- 

ministration Building  on  the  west,  through  the 

entire  length  of  the  Sanitarium  Grounds  to  the  Power  House  on  the 
east.  It  traverses  a  distance  of  1,550  feet,  connecting  the  basements  of 
the  Administration  Building,  Dining  Halls,  Service  Building,  Infirmary 
and  the  Power  House.  The  Tunnel  is  7  feet  wide  and  9  feet  high,  and 
serves  the  following  purposes : 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  67 

1.  Accommodation   of   all   service   pipes,   including   steam,    water, 
waste,  refrigeration,  electricity  and  telephone. 

2.  Transportation  of  food  to  the  Infirmary  and  of  supplies  to  the 
central  group  of  Administration  Buildings. 

3.  Underground  passageways  between  all  Sanitarium  buildings  with 
the  exception  of  Patient's  Cottages,  Nurses'  Home  and  Farm  buildings. 

The  roof  of  the  tunnel  serves  as  a  concrete  walk,  connecting  all  the 
central  buildings. 

ACKNOWLEDGMENTS 

The  successful  completion  of  the  Chicago  Municipal  Tuberculosis 
Sanitarium  offers  an  opportunity  for  an  expression  of  appreciation  of  co- 
operation on  the  part  of  several  individuals. 

Appreciation  is  due  to  Mayors  Busse  and  Harrison  for  unqualified 
support  given  to  the  Board  through  the  entire  period  of  planning  and 
construction  of  the  Institution. 

The  first  Board  of  Directors,  consisting  of  Harlow  N.  Higinbotham, 
Dr.  Theodore  B.  Sachs  and  Dr.  William  A.  Evans,  as  well  as  the  second 
Board,  of  Dr.  Theodore  B.  Sachs,  Dr.  George  B.  Young  and  W.  A.  Wie- 
boldt,  have  exerted  their  utmost  efforts  to  create  an  institution  that 
would  be  comprehensive  in  its  arrangements  to  meet  the  needs  of  a  tuber- 
culosis situation  in  a  large  city. 

During  the  entire  period  of  construction  of  the  Sanitarium  the 
Board  stood  as  a  rock  against  any  attempt  to  take  advantage  of  the  In- 
stitution. In  this  connection  the  support  of  the  Mayors,  the  Finance 
Committee  and  the  City  Council  has  been  always  unqualified  and  in  con- 
formity with  the  high  purposes  of  the  undertaking. 

Appreciation  is  due  to  Frank  E.  Wing,  the  Administrative  Secre- 
tary of  the  Board,  for  the  industry  and  executive  ability  which  charac- 
terized his  work  during  the  five  years  of  his  connection  with  the  organ- 
ization. 

To  Dr.  J.  W.  Coon,  Superintendent  of  the  Sanitarium,  is  due  credit 
for  directing  the  task  of  furnishing  the  Sanitarium  and  organizing  its 
service. 

To  the  Architects,  Messrs.  William  A.  Otis  and  Edwin  H.  Clark, 
appreciation  is  due  for  their  able,  well  balanced  and  artistic  work,  as  well 
as  for  their  cooperation  with  the  Board  in  protecting  the  interests  of  the 
public. 

O.  C.  Simonds  &  Co.  deserve  credit  for  able  execution  of  landscape 
work  and  other  ground  improvements. 


68  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

Thanks  are  due  to  a  number  of  hospital  and  sanitarium  men  in 
Chicago  and  other  cities  of  this  country  for  valuable  advice  furnished 
to  the  Committee  on  Plans,  in  the  formulation  of  the  innumerable  details, 
in  the  course  of  planning  of  the  Institution. 

The  splendid  support  given  by  this  community  and  its  newspapers 
is  most  gratefully  acknowledged. 

CONCLUSION 

On  March  9,  1915,  the  Chicago  Municipal  Tuberculosis  Sanitarium 
opened  its  doors  for  the  admission  of  patients  and  began  its  important 
task  of  efficient  institutional  treatment  of  tuberculosis  in  a  community 
whose  annual  loss  from  this  disease  in  1914  was  represented  by  3,895 
deaths. 

The  total  institutional  provision  for  tuberculosis  in  Chicago  and  Cook 
County  is  represented  today  by  2,055  beds  in  municipal,  county  and  pri- 
vate sanitaria  and  hospitals,  which  provision  is  to  be  extended  to  2,405 
beds  before  the  expiration  of  the  present  year,  by  the  addition  of  twelve 
cottages  at  the  Municipal  Sanitarium,  and  the  construction  of  a  new  pri- 
vate hospital  for  advanced  cases.  This  stands  out  most  prominently  in 
comparison  with  the  situation  eight  years  ago,  when  the  entire  institu- 
tional provision  for  the  care  of  tuberculosis  in  Chicago  and  Cook  County 
consisted  approximately  of  300  beds,  250  of  which  were  in  the  Tubercu- 
losis Department  of  the  County  Poor  House. 

This  great  result  has  been  achieved  by  a  most  persistent  and  well 
planned  anti-tuberculosis  campaign  carried  on  in  any  community  of  this 
country. 

Years  of  ceaseless  effort  gave  Chicago  this  Institution,  with  its  ulti- 
mate capacity  of  950  beds,  its  liberal  provisions  for  the  treatment  of  vari- 
ous classes  of  tuberculosis  cases,  its  240  beds  for  children,  its  maternity  de- 
partment, its  nursery  for  infants  of  tuberculous  prospective  mothers, 
its  most  comprehensive  medical  and  laboratory  facilities,  its  open  air 
quarters  for  employes,  its  splendid  medical  and  nursing  staff  selected 
by  strict  competitive  civil  service  examinations,  its  10  municipal  tubercu- 
losis dispensaries,  its  35  dispensary  physicians,  its  force  of  55  field  nurses, 
and  its  Bureau  of  Special  Relief  extending  sanitarium  methods  of  treat- 
ment to  the  homes  of  tuberculous  sufferers. 

The  achievement  gives  Chicago  the  much  needed  foundation  for  effi- 
cient control  of  a  most  widespread  disease. 

Let  this  Institution  forever  stand  as  an  expression  of  the  determina- 
tion of  the  City  of  Chicago  to  apply  its  motto  "I  Will"  in  the  solution  of 
its  great  municipal  problems. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  69 

ADDENDA 

DEDICATION   EXERCISES 
TUESDAY,  FEBRUARY  16,  1915 

The  Very  Reverend  Peter  J.  O'Callaghan,  C.  S.  P. 

Almighty  God,  Omnipotent  Father  of  us  all, 
Invocation  Eternal  Exemplar  of  justice  and  truth  and 

beauty,  Infinite  Source  of  strength  and  health 

and  life,  we  thank  Thee  for  all  that  this  day  means !  We  thank  Thee 
for  the  faith  that  makes  all  science  possible,  that  makes  us  hope  where 
there  seems  to  be  no  hope;  for  the  courage  that  cures  or  aims  to  cure 
the  incurable;  for  the  faith  in  justice  amid  many  injustices;  for  the 
faith  in  the  attainability  of  health  in  the  midst  of  disease;  for  the  faith 
in  the  attainability  of  life  in  the  midst  of  death.  We  thank  Thee  for 
the  faith  that  has  inspired  this  Institution.  We  thank  Thee  for  the  hope 
that  is  in  our  hearts  and  for  the  hope  that  we  shall  give  to  others  who 
are  sick  at  heart  as  well  as  in  body.  We  thank  Thee  for  the  charity  that 
has  made  sweet  the  labor  which  has  brought  forth  these  real  and  positive 
achievements.  We  pray  that  Thou  lay  deep  the  foundations  of  faith 
and  hope  and  charity  in  men's  souls.  Hospitals  are  not  built  of  brick 
and  mortar,  but  of  men's  ideals  and  of  men's  aspirations,  and  above  all, 
of  Thy  help  and  inspirations.  We  thank  Thee  for  all  Thy  help  in  inspir- 
ing the  creation  of  this  refuge  for  the  afflicted  and  we  pray  Thee  to 
continue  to  bless  those  who  have  made  this  Institution  a  reality  by  their 
works  of  love  and  by  their  persevering  devotion.  AMEN. 

Introductory  Address 

by 

Theodore  B.  Sachs,  M.  D.,  President  of  Board  of  Directors,  Chicago 
Municipal  Tuberculosis  Sanitarium 

Mr.  Representative  of  the  Mayor,  members  of  the  City  Council,  fel- 
low tuberculosis  workers,  ladies  and  gentlemen :  Years  of  incessant  labor, 
without  a  day's  intermission,  are  at  an  end  and  the  Chicago  Munici- 
pal Tuberculosis  Sanitarium,  completed,  stands  today  with  its  doors  open 
to  give  the  tuberculous  sufferer  in  this  City  a  chance  against  the  deadliest 
malady  of  mankind. 

It  stands  as  the  expression  of  those  finest  sentiments  of  the  com- 
munity, the  realization  of  which  marks  real  progress  toward  brother- 
hood of  man.  It  stands  as  a  haven  for  the  sufferer  and  as  a  protection 
to  the  community. 


70  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

It  was  conceived  in  the  sense  of  broadest  sympathy  and  realized 
through  years  of  toil  and  boundless  devotion  to  the  interests  of  this 
great  City. 

The  magnitude  of  this  undertaking,  the  liberality  of  the  provisions 
for  this  Institution  on  the  part  of  the  citizens  of  Chicago,  the  broad 
scope  of  the  organization  which  through  its  dispensaries,  physicians  and 
nurses  reaches  out  into  the  innumerable  recesses  of  the  tuberculosis 
problem,  the  broadness  of  the  scheme  at  present  in  operation,  is  but  an 
expression  of  the  great  forces  of  progress  which  through  all  kinds  of 
conditions  have  always  animated  Chicago  during  its  comparatively  brief 
period  of  existence  and  made  this  one  of  the  greatest  cities  of  modern 
times. 

The  Municipal  Tuberculosis  Sanitarium  Act  which  made  this  and 
similar  institutions  possible  in  the  State  of  Illinois  has  been  written  by 
a  Chicagoan,  State  Senator  Edward  J.  Glackin,  who  had  the  interest 
and  the  foresight  to  advance  all  the  anti-tuberculosis  legislation  found 
in  the  statute  books  of  the  State  of  Illinois. 

The  money,  under  the  provision  of  this  Act  for  a  special  one-mill 
tax,  became  available  in  January,  1911. 

The  site  was  purchased  in  February. 

From  the  start  the  Directors  of  the  Sanitarium  were  confronted 
with  great  difficulties.  The  sentiment  of  the  neighborhood  had  to  be 
formulated  in  favor  of  the  Institution.  The  ground  was  not  drained 
and  was  devoid  absolutely  of  any  improvements,  and  was  at  a  distance 
from  the  water,  sewerage,  gas  and  electric  lighting  systems  of  the  City. 
At  least  one  year  was  consumed  in  making  this  site  what  it  is  today,  and 
in  December,  1911,  just  three  years  ago,  the  ground  was  broken  for  the 
Power  House,  the  first  building  to  be  erected. 

The  planning  and  the  erection  of  32  buildings  proceeded  with  utmost 
dispatch,  keeping  pace  with  the  proceeds  of  the  one-mill  tax,  and  today, 
as  the  result  of  incessant  labor,  utmost  attention  to  every  detail,  ambition 
to  make  this  a  great  institution  and  yet  avoid  the  least  semblance  of 
unnecessary  ornamentation,  the  result  of  utmost  devotion  to  the  interests 
of  Chicago,  most  scrupulous  economy  extending  to  the  protection  of 
every  penny  of  the  public  money,  result  of  unceasing  labor  day  and  night, 
you  have  before  you  this  great  Institution  built  to  the  glory  of  Chicago, 
to  stamp  this  City  as  one  whose  motto,  "I  WILL,"  signifies  the  deter- 
mination to  forge  ahead,  regardless  of  any  obstacles,  and  to  deal  with 
the  great  municipal  problems  in  an  efficient  and  businesslike  way. 

The  incessant  educational  campaign  making  this  Institution  possible 
was  led  by  the  Chicago  Tuberculosis  Institute,  one  of  the  foremost  health 
organizations  in  this  City,  which,  primarily  originating  in  the  Tubercu- 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  71 

losis  Committee  of  the  Visiting  Nurse  Association,  has  for  ten  long  years 
carried  the  torch  of  light  to  every  section  of  this  community. 

This  is,  indeed,  a  most  memorable  day  in  the  history  of  the  local 
anti-tuberculosis  movement. 

The  inauguration  of  this  Institution  will  forever  stand  out  most 
prominently  in  a  health  campaign,  most  systematically  planned  and  most 
persistently  fought. 

It  marks  a  significant  advance  in  the  control  of  one  of  the  most 
important  phases  of  the  municipal  health  problem. 

The  ten  years'  campaign  carried  on  by  the  Institute  with  unceasing 
fervor  advanced  this  City  from  a  position  of  neglect  of  a  vast  army  of 
tuberculous  sufferers  in  which  the  entire  institutional  provision  in  this 
City  and  County  consisted  eight  years  ago  of  300  beds,  chiefly  in  the 
County  Institution,  to  a  position  in  which  this  City  and  County  has  today 
2,055  hospital  and  sanitarium  beds,  with  this  number  to  be  increased  to 
2,405  beds  in  one  year  from  now.  It  has,  under  the  direction  of  this  In- 
stitution, a  well  organized  system  of  ten  Municipal  Tuberculosis  Dis- 
pensaries, with  a  force  of  35  physicians  and  55  field  nurses,  who  in  the 
year  of  1914  have  studied,  treated  and  followed  up  to  their  homes  14,972 
cases,  of  which  8,595  have  proved  to  be  tuberculous.  The  Sanitarium 
has  a  Bureau  of  Special  Relief,  extending  the  advantages  of  sanitarium 
treatment  to  the  homes  of  patients,  and  it  maintains  an  educational 
propaganda  that  is  revolutionizing  the  attitude  of  this  community  toward 
the  problem  of  health.  All  this  has  been  accomplished  in  the  brief  period 
of  eight  years  and  Chicago  stands  today  acknowledged  among  the  cities 
of  this  country  for  the  comprehensiveness  of  its  municipal  plans  against 
a  disease,  the  mortality  from  which  surpasses  the  casualties  of  greatest 
wars  ever  fought  by  humanity. 

The  Chicago  Municipal  Tuberculosis  Sanitarium  is  not  simply  an 
institution  for  the  care  of  patients.  It  is  an  organization  of  a  sanitarium, 
dispensaries,  field  tuberculosis  workers,  auxiliary  activities  in  the  open 
air  schools,  a  department  rendering  available  sanitarium  treatment  at 
home  and  various  other  activities  essential  to  the  control  of  the  disease. 

The  Institution  itself  is  most  comprehensively  planned  to  meet  the 
needs  of  a  problem  of  great  magnitude  in  a  large  city.  It  provides,  in 
its  ultimate  capacity  of  950  beds,  300  beds  for  Infirmary  patients,  650 
for  ambulant  cases,  of  which  240  are  reserved  for  children.  The  infant 
of  the  tuberculous  mother  is  taken  care  of  in  a  special  nursery,  the  first 
undertaking  of  its  kind  in  this  country.  A  Lying-in  Hospital  has  its 
doors  open  to  tuberculous  prospective  mothers,  a  class  much  neglected, 
to  whom  the  City  of  Chicago  for  the  first  time  in  the  history  of  any 
country  extends  its  helping  hand. 


72  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

Various  types  of  tuberculosis  are  taken  care  of  in  special  depart- 
ments, such  as  orthopedic,  surgical,  etc.  The  discharged  patient,  with 
his  disease  arrested,  is  offered  an  opportunity  of  remunerative  labor,  con- 
sistent with  his  health,  in  an  arrangement  in  which  one-third  of  the 
housing  of  the  employes  is  in  open  air  quarters,  not  different  in  any  way 
from  the  quarters  of  the  patients. 

The  medical,  laboratory  and  X-ray  facilities  of  the  Sanitarium  make 
this  the  most  comprehensively  built  Sanitarium  of  the  times. 

The  Architects,  Messrs.  W.  A.  Otis  and  E.  H.  Clark,  have  done 
their  work  ably  and  efficiently. 

Three  years  of  incessant  labor,  without  a  day's  intermission,  created 
this  Institution  for  the  glory  of  Chicago.  The  Board  stood  all  these 
years  impregnable  in  the  effort  to  economically  and  efficiently  spend  the 
people's  money.  The  first  and  present  Board  have  stood  as  a  rock  against 
any  attempt  on  the  part  of  any  one  to  take  advantage  of  the  Institution, 
until  it  became  the  by-word  among  all  of  those  dealing  with  the  Sanita- 
rium that  the  Municipal  Tuberculosis  Sanitarium  is  a  municipal  business 
enterprise  not  different  in  any  way  from  any  other  undertaking. 

In  this  connection,  may  I  state  that  through  the  entire  period  of 
construction  of  this  Institution  the  Mayor  has  upheld  the  actions  of  the 
Board  and  lent  the  deaf  ear  to  any  attempt  on  the  part  of  anyone  to  alter 
our  course,  always  prompted  by  the  consideration  of  the  best  interests 
of  this  community.  He  has  been  a  friend  of  the  Institution  and  it  gives 
me  great  pleasure  to  state  this  on  this  public  occasion. 

To  the  City  Council  and  its  Finance  Committee  our  utmost  thanks 
are  due  for  the  uniformly  kind  attitude  and  ever  ready  co-operation. 

Mr.  Representative  of  the  Mayor,  it  is  a  source  of  pleasure  and  an 
honor,  as  President  of  the  Board  of  Directors  of  the  Chicago  Municipal 
Tuberculosis  Sanitarium  and  Chairman  of  the  Committee  on  Plans  of 
this  Institution,  to  present  to  you  the  keys  to  the  completed  Chicago 
Municipal  Tuberculosis  Sanitarium,  which  in  the  comprehensiveness  of 
its  arrangements  expresses  the  determination  of  this  community  to  ef- 
ficiently cope  with  a  great  health  problem.  Let  this  Sanitarium  always 
stand  as  an  expression  of  this  determination  of  a  City  unequaled  in 
growth  and  unparalleled  in  spirit. 

George  B.  Young,  M.  D.,  Commissioner  of  Health  and  Secretary  of 
the  Board,  Representing  the  Mayor 

The  honor  of  representing  the  Mayor  of  Chicago  in  this  connection 
is  to  me  a  most  unexpected  and,  if  I  may  be  permitted  to  say  so,  a  most 
unwelcome  honor;  unwelcome  because  I  feel  that  I  can  but  unworthily 
represent  His  Honor,  Mayor  Harrison,  who  in  his  capacity  of  advisor 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  73 

and  backer  of  the  Sanitarium  Board  has  done  so  much  to  make  possible 
the  Institution  which  you  see.  The  Mayor  greatly  desired  to  be  present 
today,  and  it  was  only  after  it  was  fully  demonstrated  that  it  would  be 
inadvisable  for  him  to  take  the  long  drive  that  he  gave  up  coming. 

His  Honor  gave  me  no  instructions  as  to  what  I  was  to  say,  and  in 
this  he  followed  the  policy  which  has  governed  him  throughout  the  con- 
struction of  the  Sanitarium.  He  has  at  no  time  given  the  Board  any 
instructions  except  to  say  that  he  wanted  the  Sanitarium  built  just  as 
well  as  it  could  be  built  and  as  speedily  as  possible. 

I  feel  justified  in  saying  on  behalf  of  the  Mayor  that  he  feels  the 
Institution  is  typical  in  many  respects  of  Chicago;  that  the  Institution 
in  the  broadness  of  the  ideals  which  inspired  it  and  in  the  completeness 
with  which  those  ideals  have  been  realized  is  typical  of  the  high  purpose 
of  the  City  of  Chicago  in  regard  to  all  public  and  civic  matters. 

This  Institution  is  unique  in  many  respects.  It  is  the  first  completed 
institution  of  any  size  for  the  City's  care  of  the  sick  and  unfortunate  of 
the  city,  and  it  is  unique  in  the  policy  which  will  be  enforced  in  the 
administration  of  its  affairs  as  provided  for  by  the  state  law  which  our 
honored  Senator  Glackin  has  done  so  much  to  put  upon  the  statute  books. 
This  is  not  an  institution  where  your  money  will  go.  The  attitude  of  the 
City  is  that  the  care  of  the  tuberculous  is  not  a  charity.  This  is  not  a 
charitable  institution;  it  provides  for  the  care  of  its  own  people.  You 
are  taking  care  of  yourself  when  you  come  here.  You  are  provided  with 
the  means  of  taking  care  of  yourself.  The  motto  of  the  Institution 
throughout  will  be :  "Good  enough  for  anybody  and  free  for  everybody." 

Mr.  Chairman,  it  gives  me  great  pleasure  to  accept  this  key  in  behalf 
of  the  Mayor-  and  to  assure  you  that  I  will  convey  it  to  him.  I  am  sure 
when  he  receives  it  he  will  be  very  proud  that  this  great  work  is  so  nearly 
approaching  completion  and  that  erection  has  been  done  during  his  term 
as  Mayor. 

W.  A.  Wieboldt,  Member  of  the  Board  of  Directors 

My  dear  associates,  Honorable  Members  of  the  City  Council,  ladies 
and  gentlemen : 

You  have  heard  a  good  deal  about  the  Municipal  Sanitarium  by  this 
time  so  that  you  are  fairly  informed  as  to  its  progress  up  to  the  present 
date.  The  greatest  work,  however,  according  to  my  ideas,  is  yet  to  come. 
That  is  the  work  which  will  have  to  be  performed  by  the  physicians  and 
nurses  of  the  Sanitarium.  The  accommodations  and  the  surroundings, 
as  you  may  already  have  noticed,  have  been  made  as  pleasant  as  possible, 
to  insure  the  comfort  of  the  patients  and  render  possible  efficient  medical 
and  nursing  work. 


74  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

The  buildings  have  been  so  planned  and  so  arranged  that  patients 
can  receive  the  best  of  care  and  the  greatest  comfort  at  the  least  expense 
to  the  municipality,  as  far  as  it  is  in  keeping  with  the  dignity  of  a  large 
city  like  Chicago. 

I  give  all  those  present  and  his  Honor,  the  Mayor,  and  all  members 
of  the  City  Council,  and  the  people  of  Chicago,  the  assurance  that  under 
the  guidance  of  Dr.  Sachs  and  Dr.  Young,  and  with  Dr.  Coon  at  the  head 
of  the  Institution  as  Medical  Director  and  Superintendent,  the  affairs 
of  the  Sanitarium  will  be  well  taken  care  of  and  I  hope  that  the  City  Coun- 
cil, as  heretofore,  will  always  provide  ample  funds  to  carry  out  the  work 
as  it  was  planned  by  the  originators  and  on  the  lines  on  which  it  has  been 
planned. 

I  hope  that  the  professional  world  and  the  scientists  will,  through 
such  work  as  the  work  of  the  Municipal  Sanitarium,  after  long  years, 
be  able  to  stamp  out  this  plague  and  that  buildings  of  this  kind  will  not 
be  necessary  and  that  160-acre  farms  such  as  this  one  can  be  then  used 
for  recreation  spots  for  old  and  young. 


Senator  Edward  J.  Glackin 

Mr.  Representative  of  the  Mayor,  President,  ladies  and  gentlemen: 

When  I  awoke  and  looked  out  upon  Chicago  this  morning  I  knew 
what  the  weather  forecaster  would  say.  His  edict  would  be  "A  dark, 
cheerless  day" — when  in  fact  it  is  one  of  the  brightest  and  happiest  days 
in  the  history  of  Chicago. 

This  Institution  is  and  will  be  a  monument  for  all  times  to  the  men 
and  women  who  have  made  it  possible  for  Chicago  to  have  this — the 
grandest  Institution  of  its  kind  in  this  country. 

I  want  to  say  a  few  words  in  regard  to  the  origin  of  this  Institution. 
Ten  years  ago,  while  a  member  of  the  House  of  Representatives,  I  saw 
the  great  need  of  an  institution  of  this  kind.  I  formulated  a  bill  for  a 
state  institution.  This  bill  was  passed,  but  vetoed  by  the  Governor  on 
account  of  insufficient  funds  in  the  State  Treasury.  Seeing  that  it  was 
utterly  impossible  to  have  a  bill  passed  providing  for  a  state  institution, 
I  formulated  a  bill  providing  for  a  municipal  tuberculosis  sanitarium.  I 
returned  to  Springfield  two  years  later,  not  as  Representative,  but  as 
State  Senator,  with  a  bill  of  this  kind,  which  carried  with  it  a  4-mill  tax. 
This  bill  was  passed  and  when  we  were  ready  to  submit  this  bill  to  a 
referendum  vote  it  was  thought  advisable  by  the  people  interested  to 
amend  the  act  by  reducing  the  tax  from  4  mills  to  1  mill.  This  was  done, 
and  at  the  present  time,  at  this  reduced  rate,  it  brings  about  $900,000 
annually. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  75 

When  submitted  to  the  people  of  Chicago  in  April,  1909,  out  of 
254,025  voters  who  cast  their  ballots  at  that  election,  206,640,  or  81  per- 
cent, voted  on  the  proposition.  To  prove  to  you  that  Chicago  welcomed 
this  Sanitarium  Act  with  open  arms,  it  received  a  tremendous  majority — 
167,230  "For"  and  39,410  "Against"  it. 

After  the  election,  Mayor  Busse  appointed  Dr.  Theodore  B.  Sachs, 
Mr.  Harlow  N.  Higinbotham  and  Dr.  William  A.  Evans  as  the  first 
Board  of  Directors. 

The  people  of  Chicago  can  never  realize  how  extremely  fortunate 
they  were  in  the  selection  of  such  able  men. 

The  question  continually  arose  as  to  whether  this  one  mill  tax  was 
separate  from  the  corporate  tax  of  the  City.  In  order  to  dispel  any  doubt 
and  to  enlarge  the  power  of  the  Board  of  Directors  to  establish  dis- 
pensaries and  to  do  any  and  all  things  which  in  their  judgment  tended  to 
prevent  or  cure  tuberculosis,  I  introduced  an  amendment  to  that  effect, 
which  was  passed  at  the  last  session  of  the  legislature. 

The  construction  period  of  this  Institution  has  been  three  years. 

The  present  Board  of  Directors  consists  of  Dr.  Theodore  B.  Sachs, 
President,  Mr.  W.  A.  Wleboldt  and  Dr.  George  B.  Young. 

Mr.  Frank  E.  Wing  is  Administrative  Secretary. 

The  Institution  as  it  stands  today  is  the  result  of  the  untiring  energy 
of  these  men. 

I  should  not  fail  to  mention  the  unqualified  support  given  by  the 
Chicago  Tuberculosis  Institute,  all  the  newspapers  of  this  city,  the  City 
Council,  the  members  of  the  Legislature,  Mr.  James  Minnick,  Superin- 
tendent of  the  Institute,  and  others  actively  engaged  in  tuberculosis  work. 

Not  only  from  the  viewpoint  of  the  people  of  Chicago,  but  from  the 
side  of  humanity,  this  noble  work,  completed  under  Mayor  Harrison's 
administration,  with  his  unqualified  support,  stands  today  as  the  greatest 
in  this  country. 

As  to  the  President,  Dr.  Theodore  B.  Sachs,  one  of  the  greatest 
authorities  on  tuberculosis,  the  people  of  Chicago  owe  a  debt  of  gratitude 
which  can  never  be  repaid  either  by  this  generation  or  generations  which 
follow. 

As  for  Dr.  Young  and  Dr.  William  A.  Evans,  whose  names  stand 
out  prominently  as  two  of  the  ablest  medical  officers  of  this  country, 
and  who  rendered  important  service  in  this  undertaking,  and  as  for  Mr. 
Harlow  N.  Higinbotham  and  Mr.  W.  A.  Wieboldt  (two  of  our  great 
men  in  the  commercial  world),  and  as  for  Mr.  Frank  E.  Wing,  Adminis- 
trative Secretary,  who  has  untiringly  devoted  his  energies  to  this  under- 
taking— the  people  of  Chicago  should  never  forget  the  noble  work 
accomplished  by  them. 


76  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

As  to  your  humble  servant,  he  sees  his  dream  realized;  sees  the 
work  completed;  sees  the  doors  open  here  to  rich  and  poor  alike,  that 
all  sufferers  may  be  helped — no  matter  what  their  position  in  life  may 
be,  the  humble  or  the  mighty,  all  on  an  equal  footing. 

As  I  worked  in  the  past  for  this  Institution,  I  shall  continue  to  the 
end.  With  the  able  assistance  of  the  Mayor,  and  the  Board  of  Directors, 
and  the  noble  men  and  women  who  have  helped  in  this  worthy  cause, 
nothing  but  success  could  crown  the  Chicago  Municipal  Tuberculosis 
Sanitarium. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  77 

ADDENDA 

THE  ILLINOIS   CITY  AND  VILLAGE  TUBERCULOSIS   LAW 

The  Act  and  Amendment  introduced  in  the  Illinois  Legislature  by  Senator 
Edward  J.  Glackin  of  Chicago.     Original  Act  passed  by  the 
Legislature  at  its  Forty-Fifth  Adjourned  Session  and 
became  operative  July  i,  1908;  first  Amend- 
ment   Passed    at    the    Forty-Sixth    Ses- 
sion    (ipopj;    second    Amend- 
ment at  the  Forty-Eighth 
Session  (1913) 

Section  i. — Be  it  enacted  by  the  People  of  the  State  of  Illinois, 
represented  in  the  General  Assembly : 

Article  i.  That  the  city  council  of  cities  and  boards  of  trustees 
in  villages  of  this  State  shall  have  the  power,  in  the  manner  hereinafter 
provided,  to  establish  and  maintain  a  public  sanitarium  and  branches, 
dispensaries  and  other  auxiliary  institutions  connected  with  same,  within 
or  without  the  limits  of  such  cities  and  villages,  for  the  use  and  benefit 
of  the  inhabitants  of  such  city  or  village  for  the  treatment  and  care  of 
persons  afflicted  with  tuberculosis,  and  shall  have  the  power  to  levy  a 
tax  not  to  exceed  one  mill  on  the  dollar  annually  on  all  taxable  property 
of  such  city  or  village,  such  tax  to  be  levied  and  collected  in  like  manner 
with  the  general  taxes  of  the  said  city  or  village  and  to  be  known  as  the 
"Tuberculosis  Sanitarium  Fund,"  which  said  tax  shall  be  in  addition  to 
all  other  taxes  which  such  city  or  village  is  now  or  hereafter  may  be 
authorized  to  levy  on  the  aggregate  valuation  of  all  property  within  such 
city  or  village,  and  the  county  clerk,  in  reducing  tax  levies  under  the 
provisions  of  section  two  (2)  of  an  Act,  entitled  "An  act  to  amend 
section  two  (2)  of  an  Act,  entitled  'An  Act  concerning  the  levy  and 
extension  of  taxes,'  approved  May  9,  1901,  in  force  July  1,  1901,  as 
amended  by  an  Act  Approved  March  29,  1905,  in  force  July  1,  1905," 
approved  June  14,  1909,  in  force  July  1,  1909,  shall  not  consider  the  tax 
for  said  "Tuberculosis  Sanitarium  Fund"  authorized  by  this  Act  as  a 
part  of  the  general  tax  levy  for  city  or  village  purposes,  and  shall  not 
include  the  same  in  the  limitation  of  three  (3)  per  cent  of  the  assessed 
valuation  on  which  taxes  are  required  to  be  extended. 

Article  2.  When  one  hundred  legal  voters  of  any  such  city  or  village 
shall  present  a  petition  to  the  city  council  or  board  of  trustees  of  such 
city  or  village,  as  the  case  may  be,  asking  that  an  annual  tax  may  be 
levied  for  the  establishment  and  maintenance  of  a  public  tuberculosis 


78  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

sanitarium  in  such  city  or  village,  such  city  council  or  board  of  trustees, 
as  the  case  may  be,  shall  instruct  the  city  or  village  clerk  to,  and  the  city 
or  village  clerk  shall,  in  the  next  legal  notice  of  the  regular  annual  election 
in  such  city  or  village,  give  notice  that  every  elector  may  vote  "For  the 
levy  of  a  tax  for  a  public  tuberculosis  sanitarium,"  or  "Against  the  levy 
of  a  tax  for  a  public  tuberculosis  sanitarium,"  and  if  the  majority  of  all 
votes  cast  upon  the  proposition  is,  that  such  city  or  village  shall  be  "for 
the  tax  for  a  public  tuberculosis  sanitarium,"  the  city  council  or  board 
of  trustees  of  such  city  or  village  shall  thereafter  annually  levy  a  tax  of 
not  to  exceed  one  mill  on  the  dollar,  which  tax  shall  be  collected  in  like 
manner  with  other  general  taxes  in  such  city  or  village  and  shall  be 
known  as  the  "Tuberculosis  Sanitarium  Fund,"  and  thereafter  the  city 
council  or  board  of  trustees,  as  the  case  may  be,  of  such  city  or  village 
shall  include  and  appropriate  from  such  fund  in  the  annual  appropriation 
bill  such  sum  or  sums  of  money  as  may  be  deemed  necessary  to  defray 
all  necessary  expenses  and  liabilities  of  such  tuberculosis  sanitariums. 

Article  J.  When  any  such  city  council  or  board  of  trustees  shall 
have  decided  to  establish  and  maintain  a  public  tuberculosis  sanitarium 
under  this  Act,  the  mayor  of  such  cities  and  the  president  of  the  board 
of  trustees  of  such  villages  shall,  with  the  approval  of  the  city  council 
or  board  of  trustees,  as  the  case  may  be,  proceed  to  appoint  a  board  of 
three  directors,  one  of  whom,  in  cities  or  villages  having  a  board  of 
health,  shall  be  from  such  board  of  health,  and  the  other  two  from  the 
citizens  at  large  and  shall  be  chosen  with  reference  to  their  special  fitness 
for  such  office. 

Article  4.  Said  directors  shall  hold  office  one-third  for  one  year, 
one-third  for  two  years  and  one-third  for  three  years  from  the  first  of 
July  following  their  appointment,  and  at  their  first  regular  meeting  shall 
cast  lots  for  the  respective  terms;  and  annually  thereafter  the  mayor  or 
president  of  the  board  of  trustees,  as  the  case  may  be,  shall,  before  the 
first  of  July  (of)  each  year,  appoint  as  before,  one  director  to  take  the 
place  of  the  retiring  director,  who  shall  hold  office  for  three  years  and 
until  his  successor  is  appointed.  The  mayor  or  president  of  the  board 
of  trustees,  as  the  case  may  be,  by  and  with  the  consent  of  the  city  council 
or  board  of  trustees,  as  the  case  may  be,  may  remove  any  director  for 
misconduct  or  neglect  of  duty. 

Article  5.  Vacancies  in  the  board  of  directors,  occasioned  by  re- 
moval, resignation  or  otherwise,  shall  be  reported  to  the  city  council  or 
board  of  trustees,  as  the  case  may  be,  and  be  filled  in  like  manner  as 
original  appointments,  and  no  director  shall  receive  compensation  as  such 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  79 

and  shall  not  be  interested,  directly  or  indirectly,  in  the  purchase  or  sale 
of  any  supplies  for  said  sanitarium. 

Article  6.  Said  directors  shall,  immediately  after  appointment,  meet 
and  organize  by  the  election  of  one  of  their  number  president  and  one 
as  secretary,  and  by  the  election  of  such  other  officers  as  they  may  deem 
necessary.  They  shall  make  and  adopt  such  by-laws,  rules  and  regula- 
tions for  their  own  guidance  and  for  the  government  of  the  Sanitarium 
and  the  branches,  dispensaries  and  auxiliary  institutions  and  activities 
connected  therewith  as  may  be  expedient,  not  inconsistent  with  this  act 
and  the  ordinances  of  such  city  or  village.  They  shall  have  the  exclusive 
control  of  the  expenditure  of  all  moneys  collected  to  the  credit  of  the 
"Tuberculosis  Sanitarium  Fund,"  and  of  the  construction  of  any  sani- 
tarium building  or  other  buildings  necessary  for  its  branches,  dispen- 
saries and  other  auxiliary  institutions  and  activities  in  connection  with 
said  institution,  and  of  the  supervision,  care  and  custody  of  the  grounds, 
rooms  or  buildings  constructed,  leased  or  set  apart  for  that  purpose: 
Provided,  that  all  moneys  received  for  such  sanitarium  shall  be  deposited 
in  the  treasury  of  said  village  or  city  to  the  credit  of  the  "Tuberculosis 
Sanitarium  Fund,"  and  shall  not  be  used  for  any  other  purpose,  and  shall 
be  drawn  upon  by  the  proper  officers  of  said  city  or  village  upon  the 
properly  authenticated  vouchers  of  the  Sanitarium  Board.  Said  board 
shall  have  the  power  to  purchase  or  lease  ground  within  or  without  the 
limits  of  such  city  or  village,  and  to  occupy,  lease  or  erect  an  appropriate 
building  or  buildings  for  the  use  of  said  sanitarium,  branches,  dispen- 
saries and  other  auxiliary  institutions  and  activities  connected  therewith, 
by  and  with  the  approval  of  the  city  council  or  board  of  trustees,  as  the 
case  may  be ;  and  shall  have  the  power  to  appoint  suitable  superintendents 
or  matrons,  or  both,  and  all  necessary  assistants,  and  fix  their  com- 
pensations, and  shall  also  have  the  power  to  remove  such  appointees,  and 
shall  in  general  carry  out  the  spirit  and  intent  of  this  act  in  establishing 
and  maintaining  a  public  sanitarium,  and  one  or  all  of  said  directors  shall 
visit  and  examine  said  sanitarium  at  least  twice  in  each  month  and  make 
monthly  reports  of  its  condition  to  the  city  council  or  board  of  trustees, 
as  the  case  may  be. 

Article  7.  Every  sanitarium  established  under  this  Act  shall  be 
free  for  the  benefit  of  the  inhabitants  of  such  city  or  village  who  may 
be  afflicted  with  tuberculosis,  and  they  shall  be  entitled  to  occupancy, 
nursing,  care,  medicines  and  attendance  according  to  the  rules  and  regu- 
lations prescribed  by  said  Board.  Such  sanitarium  shall  always  be  subject 
to  such  reasonable  rules  and  regulations  as  said  Board  may  adopt  in 
order  to  render  the  use  of  said  sanitarium  of  the  greatest  benefit  to  the 


80  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 

greatest  number,  and  said  Board  may  exclude  from  the  use  of  said 
sanitarium  any  and  all  inhabitants  and  persons  who  shall  wilfully  violate 
such  rules  or  regulations. 

Provided,  however,  that  no  person  so  afflicted  be  compelled  to 
enter  such  sanitarium,  or  any  of  its  branches,  dispensaries  or  other 
auxiliary  institutions  without  his  consent  in  writing  first  having  been 
obtained,  or  in  case  of  a  minor  or  one  under  a  disability  the  consent  in 
writing  of  the  parents,  guardian  or  conservator,  as  the  case  may  be. 

Said  board  shall,  upon  request  or  by  consent  of  the  party  afflicted  or 
the  legal  guardian,  conservator  or  parents  thereof,  have  the  power  to 
extend  the  benefits  and  privileges  of  such  institution,  under  proper  rules 
and  regulations,  into  the  homes  of  persons  afflicted  with  tuberculosis,  and 
to  furnish  nurses,  instruction,  medicines,  attendance  and  all  other  aid 
necessary  to  effect  a  cure,  and  to  do  all  things  in  and  about  the  treatment 
and  care  of  persons  so  afflicted  which  will  have  a  tendency  to  effect  a  cure 
of  the  person  or  persons  afflicted  therewith  and  to  stamp  out  tuberculosis 
in  such  city  or  village. 

And  said  board  may  extend  the  privileges  and  use  of  such  sanitarium 
and  treatment  to  persons  residing  outside  of  such  city  or  village  in  this 
State  so  afflicted,  upon  such  terms  and  conditions  as  said  board  may  from 
time  to  time  by  its  rules  and  regulations  prescribe. 

Article  8.  Said  board  of  directors,  in  the  name  of  the  city  or  village, 
may  receive  from  any  inhabitant  or  person  any  contribution  or  donation 
of  money  or  property,  and  shall  pay  over  to  said  city  or  village  treasurer 
all  moneys  thus  received  as  often  as  once  in  each  month  and  shall  take  the 
receipt  of  such  treasurer  therefor;  and  shall  also,  at  the  regular  monthly 
meeting  of  the  city  council  or  board  of  trustees,  report  to  such  city  council 
or  board  of  trustees  the  names  of  such  persons  or  inhabitants  from  whom 
any  such  contribution  or  donation  has  been  received  and  the  amount  and 
nature  of  property  so  received  from  such  and  the  date  when  the  same 
was  received.  And  said  board  of  directors  shall  make,  on  or  before  the 
second  Monday  in  June  of  each  year,  an  annual  report  to  the  city  council 
or  board  of  trustees,  as  the  case  may  be,  stating  the  condition  of  their 
trust  on  the  first  day  of  June  of  that  year,  the  various  sums  of  money 
received  from  the  "Sanitarium  Fund"  and  from  other  sources  and  how 
such  moneys  have  been  expended  and  for  what  purposes;  the  number 
of  patients  and  such  other  statistics,  information  and  suggestions  as  they 
may  deem  of  general  interest. 

Article  9.  When  such  sanitarium  is  established,  the  physicians, 
nurses,  attendants,  the  persons  sick  therein  and  all  persons  approaching 
or  coming  within  the  limits  of  the  same  or  grounds  thereof,  and  all  furni- 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  81 

ture  and  other  articles  used  or  brought  there,  shall  be  subject  to  such 
rules  and  regulations  as  said  board  may  prescribe;  and  such  rules  and 
regulations  shall  extend  to  all  branches,  dispensaries  and  other  auxiliary 
institutions  located  within  or  without  such  city  or  village  and  to  all 
employees  in  same,  and  to  all  employees  sent  to  the  homes  of  the  afflicted 
as  herein  provided  for. 

Article  10.  Any  person  desiring  to  make  any  donation,  bequest  or 
devise  of  any  money,  personal  property  or  real  estate  for  the  benefit  of 
such  sanitarium  shall  have  the  right  to  vest  the  title  to  the  money,  per- 
sonal property  or  real  estate  so  donated  to  the  board  of  directors  created 
under  this  act,  to  be  held  and  controlled  by  such  board,  when  accepted, 
according  to  the  terms  of  the  deed,  gift,  devise  or  bequest  of  such  prop- 
erty and  as  to  such  property  the  said  board  shall  be  held  and  considered 
to  be  special  trustees. 

Article  n.  All  reputable  physicians  shall  have  equal  privileges  in 
treating  patients  in  said  sanitarium. 


82 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


ADDENDA 

CLASSIFIED   STATEMENT   OF   YEARLY   EXPENDITURES 
CHICAGO   MUNICIPAL  TUBERCULOSIS   SANITARIUM 

September  1,  1910,  to  December  31,  1914 


Total  to 

16  months, 

Dec.  31. 

1910-1911. 

1912. 

1913. 

1914. 

1914. 

General  Office  Expense  — 

Salaries  — 

Officers  and  clerks. 

.  .  .$  6,684.71 

$  6,569.52 

$  6,667.90 

$10,385.33 

$30,307.46 

Rent   

1,702.00 

1,800.00 

1,200.00 

1 

,511.40 

6,213.40 

Electricity    

24.00 

36.00 

30.00 

39.50 

129.50 

Stationery,  printing  and 

of- 

fice    supplies  

579.90 

213.32 

225.42 

459.01 

1,477.65 

Postage   

170.00 

152.34 

147.82 

193.45 

663.61 

Telephone,    telegraph, 

ex- 

press,  etc  

...         142.39 

84.07 

73.40 

34.93 

334.79 

Water,  towel  supply,  clean- 

ing, etc  

75.13 

31.95 

46.50 

69.77 

223.35 

Traveling    

,    „         205.20 

462.93 

1,315.82 

1 

,615.52 

3,599.47 

Photos,  cuts,  slides,  etc. 

156.81 

49.77 

30.75 

303.38 

540.71 

Books,    magazines,    papers, 

etc  *..  . 

91.34 

51.92 

37.73 

127.91 

308.90 

Miscellaneous    

93.14 

107.08 

92.47 

375.94 

668.63 

Total    

$  9,924.62 

$  9,558.90 

$  9,867.81 

$15,116.14 

$44,467.47 

Dispensary  Dept. 

Dispensaries  — 

Salaries  — 

Physicians    

15,446.31 

20 

,108.31 

35,554.62 

Nurses   

25,144.13 

32,146.96 

36,012.70 

39 

,560.54 

132,864.33 

Clerks    

1,723.89 

2,787.30 

3,295.33 

4 

,230.24 

12,036.76 

Microscopist    

1.599.96 

1 

,439.04 

3,039.00 

Rent   

813.00 

1,370.00 

2,250.00 

3 

,319.90 

7,752.90 

Light,  heat,  cleaning,  etc..        392.21 

785.76 

1,212.05 

1 

,275.18 

3,665.20 

Supplies     

2,763.25 

3,581.75 

10,144.75 

4 

,414.02 

20,903.77 

Postage   

,  ,  .         388.83 

545.86 

369.30 

483.34 

1,787.33 

Telephone,    telegraph, 

ex- 

press,  etc  

459.35 

671.61 

751.95 

870.44 

2,753.35 

Drugs,   medicines,   etc.. 

...      1,021.85 

1,755.23 

2,583.52 

3 

,389.26 

8,749.86 

Nurses'  car  fares  

1,236.36 

1,342.36 

1,436.89 

1 

,324.02 

5,339.63 

T  aundry    

-     386.91 

620.07 

837.11 

1 

,130.69 

2,974.78 

Miscellaneous    

222.25 

376.58 

335.95 

761.93 

1,696.71 

Total    

,   $34,552.03 

$45,983.48 

$76,275.82 

$82,306.91 

$239,118.24 

Bureau  of  Special 

Relief— 

Total  . 

I 

,181.19 

1,181.19 

Open  Air  Schools — 

Salaries— Physicians 867.95  867.95 

Nurses    3,472.81  3,472.81 

Drugs    3.10  3.10 

Food 7,235.27  7.235.27 


*Total    $11,579.13     $11,579.13 


Educational  Dept. — 

Total    1,222.87 


4,276.08         5,498.95 


*Open  Air  School  expense  for  1912  and  1913  included  in  Dispensary  Dis- 
tribution. 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


83 


Total  to 
Dec.  31, 
1914. 


1,782.05 


CLASSIFIED  STATEMENT— Continued 

16  months, 

1910-1911.  3912.  1913.  1914. 

Sanitarium — 
Administration — 

Total $     1,782.05  

House  and  Property 

Expense — 

Electricity    and    sup- 
plies  $        132.63  $          91.48  $  224.11 

Fuel — Coal,  wood  and 

kindling 3,060.89         5,696.18  8,757.07 

Oil,  waste  and 

gasoline 171.69  93.18  264.87 

Maintenance — Real 
Estate  and  Bldgs.— 
Salaries      and 

wages     3,134.27        3,134.27 

Materials  and  sup- 
plies       10.46  10.46 

Maintenance — Ma- 
chinery and  Tools — 
Salaries      and 

wages 6,706.40       13,805.32          20,511.72 

Materials  and  sup- 
supplies     744.81  584.81  1,329.62 

Insurance     3,982.00  3,982.00 

Miscellaneous     105.18  127.17  232.35 


Total $   14,055.87  $  24.390.60  $      38,446.47 


Total    Sanitarium  14,055.87 

Equipment — 

General  office $  771.55$  301.80  299.18 

Dispensary  Dept. — 

Central  office 406.15  54.74       

Dispensaries  947.15  1,031.04  503.67 

Educational 

Sanitarium  . .  .  527.85 


26,172.65          40,228.52 


353.02 

249.23 

875.14 

1.40 

3,332.37 


1,725.55 

710.12 

3,357.00 

1.40 

3,860.22 


Total     $     2,124.85$     1,387.58$     1,330.70$     4,811.16$        9,654.29 

Miscellaneous — 

Sanitarium — Ground 

and    improvem'ts  163,235.31       29,466.80 
Bldgs.  and  archi- 
tects'   fees...        9,938.05     268,510.23 


41,160.43       47,426.72 
758,712.17     515,115.73 


281,289.26 
1,552,276.18 


Total    $173,173.36  $297,977.03  $799,872.60  $562,542.45  $1,833,565.44 

Dispensary  Dept. — 

Land 9,750.00  9,750.00 

Architects'  fees 1,200.00  1,200.00 


Total $  10,950.00 

Total   Miscellaneous .  $173,173.36  $297,977.03  $799,872.60     573,492.45 

Total  expense  as 
shown  by  Ex- 
p  e  n  s  e  Distribu- 
tion Ledger  ....$219,774.86  $354,906.99  $902,625.67  $718,935.71 

Bal.  in  G.  O.  stores . .          566.25        

Reduction     in     stores 

account 23.56  26.13        

Inc.  in  stores  acct 98.01 

Grand 


5      10,950.00 
1,844,515.44 


$2,196,243.23 

614.57 


total     of 
expenditures $220,341.11  $354,883.43  $902,599.54  $719,033.72  $2,196,857.80 


84 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


ADDENDA. 

RECEIPTS  AND  EXPENDITURES  BY  YEARS 
Also  Available  Balance  January  1  of  Each  Year 

Sept.  1,  1910,  to  Dec.  31,  1911 
Receipts: 

Revenue  from  Taxes  (Levy  of  1910) $407,937.39 

Miscellaneous   Revenue    315.00 

Accrued  Interest  on  Deposits  to  Nov.  30,  1911 915.88 

Total   Receipts $409,168.27 

Expenditures : 

General  Office  Stores  Account  (Supplies  on  Hand  in 
Storeroom,   Available    for    Future    Requisition    by 

Various  Departments)    $        566.25 

General  Office — Administration 9,924.62 

Dispensary  Department  34,552.03 

Equipment — General  Office  and  Dispensary  Dept....  2,124.85 
Sanitarium  Department: 

Land  and  Improvements 163,235.31 

Buildings  (Architects'  Fees,  $9,000.00) 9,938.05 

Total  Expenditures $220,341.11 

Available  Balance  Dec.  31,  1911 $188,827.16 

Jan.  1  to  Dec.  31,  1912 
Receipts: 

Unexpended  Balance  Jan.  1,  1912 $188,827.16 

Revenue  from  Taxes  (Levy  of  1911) 268,857.77 

Miscellaneous  Revenue 150.00 

Accrued  Interest  on  Deposits,  Dec.  1,  1911,  to  Nov. 

30,  1912 5,521.44 

Total  Receipts     $463,356.37 

Expenditures: 

Gen'l  Office — Administration  $     9,558.90 

Dispensary  Department $  45,983.48 

Less  Reduction  in  Stores  Account 23.56       45,959.92 

Account 23.56         45,959.92 

Equipment — 

General  Office  $        301.80 

Dispensary  Department 1,085.78         1,387.58 

Sanitarium: 

Ground  Improvements  (Sewer  and  Water 

Lines  and  Landscape  Work) $  29,466.80 

Less  Rebate  on  1911  Assessment  for 

Water  Main  on  40th  Avenue 1,996.28       27,470.52 

Buildings: 

Construction   $237,174.46 

Architects'  Fees   28,657.77 

Clerks  of  the  Works 2,678.00     268,510.23 

Total  Expenditures $352,887.15 

Available  Balance,  December  31,  1912 $110,469.22 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


85 


ADDENDA. 

RECEIPTS  AND  EXPENDITURES  BY  YEARS— Continued 
Jan.  1,  1913,  to  Dec.  31,  1913 

Receipts: 

Unexpended  Balance  Jan.  1,  1913 $110,469.22 

Revenue  from  Taxes  (Levy  of  1912) $900,759.28 

Less  Interest  on  Tax  Warrants 115.89  900.643.39 

Miscellaneous  Revenue 55.00 

Accrued  Interest  on  Deposits,  Dec.  1, 

1912,  to  Nov.  30,  1913 3,776.96 

Total  Receipts $1,014,944.57 

Expenditures : 

General  Office — Administration  $     9,867.81 

Dispensary  Department  76,275.82 

Less  Reduction  in  Stores  Account 26.13       76,249.69 

Equipment: 

General  Office   299.18 

Dispensary  503.67 

Sanitarium 527.85         1,330.70 

Sanitarium  Maintenance  14,055.87 

Educational 1,222.87 

Miscellaneous: 

Ground  Improvements   41,160.43 

Buildings 758,712.17     799,872.60 

Total  Expenditures $   902,559.54 

Available  Balance,  Dec.  31,  1913 $112,345.03 

Jan.  1,  1914,  to  Dec.  31,  1914 

Receipts: 

Unexpended  Balance  Jan.  1,  1914 $112,345.03 

Revenue  from  Taxes  (Levy  of  1913) 900,702.22 

Miscellaneous  Revenue 3.37 

Accrued  Interest  on  Deposits  Dec.  1,  1913,  to  Nov. 

30,  1914 ". 4,742.57 

Total  Receipts "  $1,017,793.19 

Expenditures : 

General  Office — Administration $  15,116.14 

General  Office — Increase  in  Stores 98.01 

Dispensary  Department: 

Dispensaries   $  82,306.91 

Bureau   of  Relief 1,181.19 

Open  Air  Schools 11,579.13       95,067.23 

Educational  Department — Exhibit 4,276.08 

Sanitarium  Department: 

Administrative  Expense  1,782.05 

General  House  and  Property  Expense..     24,390.60       26,172.65 
Equipment: 

General  Office   353.02 

Dispensary  Department  1,124.37 

Exhibit  1.40 

Sanitarium 3,332.37         4,811.16 

Miscellaneous: 

Sanitarium — Ground  Improvements  ....     47,426.72 

Buildings  and  Architects'   Fees 515,115.73 

Dispensary  Department — Land 9,750.00 

Architects'  Fees 1,200.00     573,492.45 

Total  Expenditures ~~  $    719,033.72 

Available  Balance  Dec.  31,  1914 $298,759.47 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


ADDENDA 

MORTALITY  STATISTICS  FROM  TUBERCULOSIS  IN  CHICAGO. 
(HEALTH  DEPARTMENT) 

i  Number  of  Deaths  —  \ 

/  Death  Rate  per  100,000  * 

Year 

Pulmonary 

Other 

All  Forms 

Pulmonary 

Other 

All  Forms 

1871  

500 

329 

829 

149.6 

98.4 

248.0 

1872  

710 

299 

1,009 

193.3 

81.4 

274.6 

1873  

639 

291 

930 

168.2 

76.6 

244.7 

1874  

630 

234 

864 

159.3 

59.2 

218.5 

1875  

694 

186 

880 

173.3 

46.4 

219.7 

1876  

732 

154 

886 

179.6 

37.8 

217.3 

1877  

733 

180 

913 

170.5 

41.9 

212.3 

1878  

697 

159 

856 

159.6 

36.4 

196.0 

1879  

745 

109 

854 

151.6 

22.2 

173.7 

1880  

875 

106 

981 

173.9 

21.1 

195.0 

1881  

1,059 

132 

1,191 

196.1 

24.4 

220.6 

1882  

1,055 

128 

1,183 

188.1 

22.8 

211.0 

1883  

1,035 

115 

1,150 

178.4 

19.8 

198.3 

1884  

1,035 

150 

1,185 

164.3 

23.8 

188.1 

1885  

1,181 

108 

1,289 

177.6 

16.2 

193.8 

1886  

1,230 

147 

1,377 

174.8 

20.9 

195.7 

1887  

1,373 

167 

1,540 

180.7 

22.0 

202.6 

1888  

1,462 

154 

1,616 

182.1 

19.2 

201.3 

1889  

1,542 

150 

1,692 

164.9 

16.0 

181.0 

1890  

2,010 

211 

2,221 

182.8 

19.2 

201.9 

1891  

2,120 

280 

2,400 

184.5 

24.4 

208.9 

1892  

2,187 

196 

2,383 

182.3 

16.3 

198.6 

1893  

2,362 

285 

2,647 

188.5 

22.7 

211.2 

1894  

2,191 

308 

2,499 

167.4 

23.5 

191.0 

1895  

2,174 

289 

2,463 

159.1 

21.1 

180.2 

1896  

2,319 

348 

2,667 

162.4 

24.4 

186.8 

1897  

2,182 

392 

2,574 

146.4 

26.3 

172.6 

1898  

2,416 

413 

2,829 

155.2 

26.5 

181.7 

1899  

2,516 

394 

2,910 

154.7 

24.2 

178.9 

1900  

2,599 

354 

2,953 

153.0 

20.8 

173.9 

1901  

2,495 

379 

2,874 

142.4 

21.6 

164.0 

1902  

2,556 

423 

2,979 

141.9 

23.5 

165.4 

1903  

2,869 

508 

3,377 

155.0 

27.5 

182.5 

1904  

3,131 

412 

3,543 

164.8 

21.7 

186.5 

1905  

3,203 

471 

3,674 

164.6 

24.2 

188.8 

1906  

3,224 

613 

3,837 

161.3 

30.7 

192.0 

1907  

3,512 

527 

4,039 

171.5 

25.7 

197.2 

1908  

3,418 

497 

3,915 

163.0 

23.7 

186.7 

1909  

3,346 

539 

3,885 

155.9 

25.1 

181.0 

1910  

3,366 

542 

3,908 

153.3 

24.7 

178.0 

1911  

3,313 

413 

3,726 

147.5 

18.5 

166.0 

1912  

3,243 

520 

3,763 

141.32 

22.66 

163.98 

1913  

3,298 

568 

3,866 

140.69 

24.23 

164.92 

1914  

3,384 

524 

3,908 

141.39 

21.89 

163.28 

CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


87 


ADDENDA 


STATISTICS  OF  MUNICIPAL  REGISTRATION   OF  TUBERCULOSIS   IN 

CHICAGO. 

(HEALTH  DEPARTMENT) 

Year 19061907     1908     1909     1910     1911     1912     1913       1914 

Number  of  cases— all   forms.. 277     919    2,577    4,089    6,121    8,152    7,512    9,315    10,009 


EXAMINATIONS  OF  SPUTUM 

By  the  Bacteriologist  of  the  Dispensary  Department 

of    the    Chicago    Municipal    Tuberculosis    Sanitarium 

(Stationed  in  the  Laboratory  of  the  Health  Department, 

City  Hall,  Chicago) 


YEAR 

NUMBER  OF 
EXAMINATIONS 

POSITIVE 

NEGATIVE 

1913 

4,666 

1,258 

3,408 

1914 

6,558 

1,796 

4,762 

TOTAL 

(2  Years) 

11,224 

3,054 

8,170 

CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


ADDENDA 


Relative  Number  of  MEN.  WOMEN  and  CHILDREN 
in  Incipient.  Moderately  Advanced  and  Far  Advanced  Stages 

Of  PULMONARY  TUBERCULOSIS 

on  admission  to  CHICAGO  MUNICIPAL  TUBERCULOSIS  DISPENSARIES 
During  the  Period-*  Jan.  1.1912  *  Sept  50. 1914.  C2Yr».9Mos) 

Figures    based  on  5458  POSITIVE  CASES  -  1576 Men;  2l55Women;  746Children. 


1912 


1915 


19H  (9  Mos.) 


Entire  Period 


Per  Cent 


Per  Cent 


Per  Cent 


Per  Cent 


Incipient 


Incipient 


MEN  WOMEN  CHILDREN 

t2.0f 


MEN  WOMEN         CHILDREN 


. 


Incipient 


_ 


Incipient 


MEN  WOMEN         CHILDREN 


05 


Mod.  Advanced 

1EN  NTOMEN          CHILDREN 


Mod.  Advanced 

MEN  WOMEN  CHILDREN 


.</,. 


Mod.  Advanced 


Mod.  Advanced 

MEN  WOMEN          CHILDREN 


Far  Advanced 


MEN  WDMEN          CHILDREN 


Far  Advanced 

MEN  WOMEN         CHILDREN 


Far  Advanced 

N  \TOMEN          CHILDREN 


Far  Advanced 

N  WOMEN  CHILDREN 


D 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


80 


ADDENDA 


CLASSIFICATION  / 
Of  10.550  Cases  of 

CHICAGO  MUNK 
Seven  Year  P 

\ccording  to  STAGE  of  the  PIS  E 
PULMONARY  TUBERCULOSIS  C 

ASE 
ill  ages) 

ARIES 

k 

on  admission  to 
;IPAL  TUBERCULOSIS  DISPENS 
eriod  -  Oct  1.  19O7~  Sept.  5Q  19H 

/     1907 

1906         1909 

191O 

1911 

1912 

1915 

1914 

/ 

^         i       n      m       i 

n      m       i       n      ra 

i 

n 

m 

T" 

n 

m 

I 

n 

m 

T" 

n 

m 

NcmeNr 

.-WDAOV 

m 

60 

930                      v          I2Z6 
TP  £  DIM  NOSES     POSITI>  I  DIAO  4OSES 

POSITI 
fl 

070 

t   DIA 

NOSES 

P05IT1 

n 

PIL 

IOSES 

POJITI 

& 

1798 

t  DIA 

•IOSU 

fOSITI 

2002 
t  DIAG 

M»U 

P05,Tr 

1654 
t   OIAO 

"• 

a. 

so                         I 

tf 

:: 

~" 

• 

r 

B 

;•  ; 

> 

, 

,\ 

S  ; 

\ 
J0_      \-      Kg               v 

|    -            $g 

- 

^ 

. 

20 

r 

:  • 

n 

. 

; 

X 

ITT    U 

r*f 

-Alf- 

•.'• 

| 

: 

jU* 

< 

(1 

H 

1 

1 

TheNIGHT  CLINIC 

versus  the  DAY  CLINIC  as  a 

Means  of  EARLY  DETECTION  of  PULMONARY  TUBERCULOSIS 

Experience  during  the  past  3j 
IROQUOIS  MEMORIAL 
in  DAY  CLINICS  o 
CHICAGO  MUNICIPAL 

TheNIGHT  CLINIC    shows  higher 

ears  in  the  NI 
DISPENSARY 
all  other  Dis 
TUBER.CULC 

The 
perce 

3HT  CLINIC  of  i 
as  compared  with  t 
sensaries  of  the 
)SIS  SANITARJUV 

NIGHT  CLINIC 

he 
hat 

[ 

hows  higher 
DIAGNOSES 

percentage  of  POSITIVE  DIAGNOSES 

nta?e  of    EAR.LY 

v^     1911        19 

15           19l4(9Mo) 

Diagnosis 
STAGE  c 

according 
o 
f  Disease 

191-2 

1915 

1914  (9Mo) 

DAY  CLINICS 

NIGHT  CLINK 

.AYCUN« 

N,OHTCU»K 

DAY  CLINICS 

NIOHTCUNK 

"°~   TCUK,    -VCU*, 

£S 

"""I 

A6NOSU 

«cn, 

£%£' 

EkCfM 

Z^S 

n,CS« 

oimvi 

PtKCEKT 

oumi 

PttCtKT 

~   -     — 

Incipient 

H, 

S17U 

to 

fan 

to* 

7*/Z 

it 

^ 

A9 

4K«r 

7S 

«Jt 

Mod.  Advanced 

541 

MStZ 

14 

n.st 

**     t 

«<»t 

a 

«« 

M 

*fc* 

a 

*n 

70 

Far  Advanced 

in 

/0.4ft 

1 

t.4t 

OS   1 

jot 

3 

M 

K0 

XJ05? 

- 

- 

00        fe                      « 

il 

Total 

m, 

M>* 

71 

toot 

1766 

/<««" 

no 

Aw* 

1574 

«rt 

to 

foot 

50    P           r 

ji 

Experience  in    ast  3^yearj 
NIGHT  CLINIC 

_J£.                     % 

fe      v/^////////y^////^^^ 

20        ^          \          '^/, 

DAY  CLINICS    ' 

-|--|--p-            ^ 

/////// 

////////////////////////A                     •     ••% 

m 

90  CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


ADDENDA 

DIRECTORY  OF  TUBERCULOSIS  INSTITUTIONS  IN 
CHICAGO  AND  COOK  COUNTY 

Private  Sanitaria  and  Hospitals  Capacity 

Edward  Sanatorium,  Naperville,  Illinois 95  beds 

Chicago  Fresh  Air  Hospital,  Chicago,  111...      95  beds 
Chicago-Winfield  Sanatorium,  Winfield,  Illi- 
nois            95  beds 

Ridge  Farm  Preventorium,  Deerfield,  Illinois.      27  beds 
Home   for  Destitute  and   Crippled   Children, 

1653  Park  Avenue,  Chicago,  Illinois 26  beds 

Otto  Young  Pavilion,  Department  of  the  Home 
for  Incurables,  57th  Street  and  Ellis  Ave- 
nue, Chicago,  Illinois 68  beds  

Total   406  beds 

Public  Sanitaria  and  Hospitals 

Chicago  Municipal  Tuberculosis  Sanitarium, 
North  Crawford  and  Bryn  Mawr  Ave- 
nues, Chicago,  Illinois,  capacity  on  the 
day  of  opening 650  beds 

Tuberculosis  Department  of  the  Cook  County 

Hospital,  Lincoln  near  Harrison  Street. . .    324  beds 

Tuberculosis  Department  of  the  Cook  County 

Infirmary,  Oak  Forest,  Illinois 675  beds 

Total    .   1,649  beds 


2,055  beds 

Illinois  Sanitaria  Outside  of  Cook  County 
Private 

Ottawa  Tent  Colony,  Ottawa,  Illinois 60  beds 

Springfield  Open  Air  Colony,  Springfield,  Illinois 30  beds 

Harrison   Tuberculosis    Colony   Association,   Collinsville, 

Madison  County,  Illinois 12  beds 

The  Olney  Sanitarium,  Olney,  Richmond  County,  Illinois 

(Limited  number  of  tuberculous  patients) 

Public 

Lake  Breeze  Sanatorium,  Waukegan,  Illinois 32  beds 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM  91 


ADDENDA 

DIRECTORY   OF   TUBERCULOSIS    ORGANIZATIONS 
IN  CHICAGO 

THE  CHICAGO  TUBERCULOSIS  INSTITUTE, 

Room  1212,  No.  8  South  Dearborn  Street,  Chicago,  Illinois. 

Theodore  B.  Sachs,  M.  D.,  President. 
Sherman  C.  Kingsley,  Secretary. 
James  Minnick,  Superintendent. 

THE  ILLINOIS  STATE  ASSOCIATION  FOR  THE  PREVENTION  OF  TUBERCULOSIS 
Room  1212,  No.  8  South  Dearborn  Street,  Chicago,  Illinois 

George  Thomas  Palmer,  M.  D.,  Springfield,  Illinois,  President. 
James  Minnick,  Chicago,  Secretary. 

THE  JEWISH  CONSUMPTIVES'  RELIEF  SOCIETY, 

West  Side  Trust  &  Savings  Bank  Building,  Southeast  Corner  of 
12th  and  Halsted  Streets,  Chicago,  Illinois. 

Mrs.  I.  J.  Robin,  President. 
Mrs.  L.  C.  Barnett,  Secretary. 


92 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


ADDENDA 

DISPENSARY  DEPARTMENT 
Of  the  Municipal  Tuberculosis  Sanitarium 


MEDICAL  ADVISORY  STAFF 


Ethan  A.  Gray 
Theodore  B.  Sachs 
Charles  Segal 
O.  W.  McMichael 


John  Ritter 
James  J.  Cole 
Clarence  L.  Wheaton 
Katharine  B.  Rich 


George  A.  Gardner 
Clyde  D.  Pence 
H.  C.  Miller 
Stephen  R.  Pietrowicz 


ATTENDING  DISPENSARY  PHYSICIANS 


James  J.  Cole 
George  A.  Gardner 
O.  W.  McMichael 


Wilson  R.  Abbott 
Maurice  L.  Blatt 
George  N.  Beecher 
Max  Biesenthal 
Willard  W.  Dicker 
William  G.  Epstein 
Frank  J.  Fara 
Meta  E.  Franke 


Head  Physicians 

H.  C.  Miller 
Clyde  D.  Pence 
Katharine  B.  Rich 
Stephen  R.  Pietrowicz 

Attending  Physicians 

George  Halperin 
Robert  H.  Hayes 
Edward  N.  Heacock 
Arthur  H.  R.  Krueger 
Max  I.  Leviton 
Maurice  Lewison 
Patrick  E.  Mills 
N.  C.  Nelson 


John  Ritter 
Charles  Segal 
Clarence  L.  Wheaton 


Eugene  J.  O'Neill 
William  E.  Putz 
Maurice  Reinhart 
C.  T.  Shearer 
Solomon  Strouse 
Isadore  M.  Trace 
G.  W.  Wagner 


Volunteer  Physicians 
A.  Wilberforce  Williams  H.  C.  Hardt 

FIELD  NURSES 
Superintendent  of  Field  Nurses 

Rosalind  Mackay 
Head  Field  Nurses 


Barbara  H.   Bartlett 
Olive  E.  Beason 
Katherine  M.  Canfield 
Fannie  J.  Davenport 


H.  Winifred  Alder 
Anna  G.  Barrett 
Ella  M.  Bland 
Mabel  F.  Cleveland 
Elrene  M.  Coombs 
Delia  L.  Corbett 
Margaret  M.  Coughlin 
Stella  W.  Couldrey 
Emma  W.  Crawford 
Laura  E.  Crawford 
Roxie  A.  S.  Dentz 
C.  Ethel  Dickinson 
Mary  Elizabeth  Egbert 
Sara  D.  Faroll 
Mary  Fraser 
Augusta  A.  Gough 
Pearl  Guynes 


Anna  M.  Drake 
Maude  F.  Essig 
Frances  M.  Heinrich 
Mary  MacConachie 

Field  Nurses 

Margaret  Hanrahan 
Emma  C.  Hedlund 
Laura  K.  Hill 
Isabella  Jensen 
Gena  Johnson 
Emma  E.  Jones 
Letta  D.  Jones 
Jeanette  Kipp 
Elsa  Lund 
Allie  McBothe 
Isabel  McKay 
Anna  V.  McVady 
Mary  S.  Marcus 
Josephine  V.  Mark 
Gertrude  A.  Martin 
Helen  W.  O'Malley 


Annie  Morrison 
Grace  M.  Saville 
Mabelle  E.  Smith 
Florence  Spencer 


Gertrude  Parish 
Katherine  M.  Patterson 
Ethel  V.  Peckham 
D.  E.  Poston 
Laura  A.  Redmond 
Ethel  Rinker 
Beryl  Scott 
Lelia  C.  Sears 
Florence  T.  Singleton 
Ellen  Sizelove 
Harriette  E.  Stahley 
Genevieve  E.  Stratton 
Eva  C.  Stroulger 
Annabel  B.  Stubbs 
Alice  J.  Tapping 
Elizabeth  M.  Watts 


Ida  A.  Bengston,  Bacteriologist 
Karla  Stribrna,  Interpreter 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


93 


INDEX 


Page 

Accessibility   of  site 15 

Activities  of  Sanitarium 37 

Administration  Building, 

— provisions    43 

— description  of    43 

— facilities,  medical  and 

laboratory   38,  43,  45 

— floor  plans 44 

Annex,  patients'  cottages 55 

Architects 17,  72 

Arrangement, 

— buildings    21 

—medical    38,  43 

Assembly  room, 

— patients   39 

— in  children's  cottages 59 

— in  Nurses'  Home 63 

Autopsy  room,  location  of 40,50 

Bakery,  location  of 48 

Barns  (see  farm  buildings) 
Bath  and  toilet  facilities, 

— Administration   Building    45 

—Children's  Cottages  59 

— employes,  male   65 

— employes,  female    48 

— Infirmary   Admin.    Bldg 51 

— men's,   women's   Infirmary. ..  .52,  53 

— Nurses'  Home 62,  63 

— open    air    wards 52,  53 

—Patients'   Cottages 57 

— Farm  House  66 

— Service  Building   48 

— Unit  Administration  Building...   61 

Bed  rooms,  double, 

— Administration   Building    ....   44,  45 

— Farm  House 66 

— Infirmary  Building 51,  52,  53 

—Nurses'  Home  62,  63 

—Service    Building    47,  48 

Bed  rooms,  single, 

— employes,  male   65 

—Infirmary     51,  52,  53 

— isolation    quarters    52,  53 

—Nurses'    Home    62,  63 

Board  of  Directors, 

— appointment    by    law 12,77 

—first  Board    . . ." 14,  67,  75 

— fix   admission,    non-residents....    13 

— second   Board    19,  67,  75 

Board  of  Education,  co-operation.   60 

Boilers    28,65 

Boiler  house  (see  power  house). 


Page 

Bulletins,  publication    34 

Business  office,   location 43,45 

Butcher  shop   48 

Campaign    for    Municipal    Sanita- 
rium       10 

Capacity    37,  68 

Chapel,   space    22 

Charities,  Bureau  of 26 

Chicago  Tuberculosis  Institute, 

— amended  law,  campaign  for 10 

— tuberculosis  exhibit   34 

— dispensaries  taken  over 14 

Children — (see  patients) 
City  Tuberculosis  Sanitarium, 

— an  Act 9 

— present   law    12,  77 

Comfort  stations,  public 45,  51 

Committee  on  plans   17 

Confinement  room  41 

Construction  begun  11 

Contagious  diseases  (see  Isolation). 

Contents   5,  6 

Costs,  ^ 

— Administration   Building    45 

—Adult  Patients'  Cottages 58 

—Children's  Cottages 60 

— Farm  Buildings 66 

—gate  lodge  66 

— Infirmary  group  51 

— Nurses'    Home    61 

— Power  House  and  Laundry 64 

— Service  Building  49 

— Transformer  Station ,   66 

— Unit  Administration  Building...   61 

Cottages,  adult, 

— capacity,   exposure,   number  and 

separate  groupings 22 

— description 55 

— distance      from      administration 

buildings    , .   22,  53 

— preparation  of  plans 17 

Cottages,  children's, 

— capacity,  each    41,  60 

— description 58 

— exposure  and  location 55 

— separate  from  adults 60 

County     Tuberculosis     Sanitarium 

Act    13 

Culinary  department   45 

Dedication    3 

Dental, 

— conditions,  treatment  of 41 

— room       28,  45 


94 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


INDEX— Cont'd 


Page 
Diets  (see  diet  kitchen) 

Dining  halls,  ambulant  patients, 

— description  and  location 47,48 

— layout  of   22 

Dining  halls,   Infirmary, 

— description    46 

— location    51,  53 

Dining  halls,   employes 48 

Dining    halls,    medical    staff    and 

nurses  46,  48 

Directory  of  Tuberculosis  Institu- 
tions       90 

Directors  (see  Board  of) 
Directory  of  Tuberculosis   Organ- 
izations       91 

Disinfecting  rooms    28,  51 

Dispensary  system, 

— dispensary  locations    31 

— functions    25,  35 

— organization   14 

— relief  department   32 

— report  of   31 

Dressing    rooms    (see    locker    and 

dressing  rooms) 
Drives  (see  walks  and  drives) 

Dry  room,  laundry 65 

Dynamo,  auxiliary  65 

Education, 

— dispensary  features    25 

— exhibits  and  literature 34 

Electric  light  and  power 65,66 

Employes, 

— dispensaries    31 

— ex-patients,  provisions    42 

— dining  halls    48 

— quarters,  male  and  female. 42,  48,  65 

— quarters,  plans    19 

— recreation  room 48 

Emergency  hospital,  children 59 

Examination   rooms    38,51,61 

Exhibit,  Tuberculosis   34 

Exhibition  Room,  South  Side  Cen- 
tral Dispensary  28 

Ex-patients,  open  air  quarters....   42 

Expenditures,  yearly  82 

Experimentation  room 38,  43 

Facilities,  medical  and  laboratory.   38 

Farm  buildings   22,  66 

Features    of   organization 25 

— of  sanitarium   proper 37 

Fence    .  .   66 


Finance    Committee 
Food,    distribution.. 


Page 

.  ..16,17,  67,72 
46,48,67 


Garage  (see  farm  buildings). 

Gate  Lodge 66 

Grounds, 

— for  ambulant  cases 53 

— children's  recreation    60 

— male  and  female  recreation 39 

— description    20 

— nurses'   recreation    63 

— recreation    55 

Grouping  of  buildings 18 

Housekeeping   department    48 

House  of  Social  Service 27 

Ice  making  machine 65 

Illinois  City  and  Village  Tubercu- 
losis  Law    12,  77 

Illustrations,  List  of 7 

Incinerator  room    64 

Infants  (see  nursery). 
Infirmary  group, 

— Administration   Building    51 

— capacity 22 

— contagious  disease  ward 52,  53 

— description  and  location 22,49 

— medical  and  laboratory  facilities  38 
— men's  and  women's  infirmary. 52,  53 
— nose  and  throat  department....  40 

— orthopedic    department    41,51 

— surgical  department    41,51 

— X-Ray  room 51 

Isolation  of  contagious 

diseases 42,  52,  53 

Kitchens,  Diet, 

— dispensary  28 

— Infirmary  group 50,  52,  53 

— nurses   63 

— Unit  Administration  Building...  61 
Kitchen,  main  47,  48 

Laboratory, 

— dispensary     28 

— Infirmary 51 

— main    44,  45 

— study   of    cases 40 

— Unit  Administration  Building...   38 

Laundry     22,  63 

Lavatory,    dental    50,  57,  58,  59 

Law  for   City  Sanitarium 12,77 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


95 


INDEX-Cont'd 


Page 

Law  for  County  Tuberculosis  San- 
itarium        13 

Law  for  State  Sanitarium 9 

Lawns     22,  49,  55 

Layout  of  buildings 21 

Library 45 

Living  rooms, 

— Infirmary  Administration   Build- 
ing    51 

—Patients'  Cottages   55,  56 

— Service  Building  48 

Location  of  Sanitarium 17,  20 

Locker  and  dressing  rooms, 

— Children's  Cottages 59 

— Infirmary 50,  52,  53 

— Patients'  Cottages  >  . .   57,  58 

— Power  House 65 

— Service  Building  48 

— Unit  Administration  Building...   61 

Mackine  room  51 

Maternity  department    41,53 

Mayor,  appoints   Board 12,  77 

Medical  and  laboratory  facilities, 

— of  Infirmary  49 

—for    study    38 

Medical  Director, 

— office    and   quarters 38,  45 

Mortality  statistics    86 

Nose  and  throat, 

— conditions,  study  and  treatment.   40 

—room   28,  51,  61 

Nursery     42,  50,  53 

Nurses,  dispensary  department, 

— number 15,  31,  92 

— Tuberculosis   Study   Circle 34 

Nurses'  Home, 

— description  and  location 22,61 

Nurses,   Sanitarium, 

— conference   room    38,  45 

— dining  hall    48 

— offices    and    rooms. .  .38,  51-53,  59,  61 
— superintendent's   office    38,45 

Objections  to  purchasing  site...  16,  17 

Open  air  school 28,  41,  59 

Open  air  wards 48,  50,  52,  53 

Orthopedic  department    ..28,41,49,51 


Page 
Patients,  ambulant, 

— assignment  to  cottages 53 

—capacity    22,  37,  39 

— dining  halls 49 

— examinations    39,  40 

— grounds  and  quarters 53 

— surgical   dressing  room 41 

— supervision 60 

Patients,  children, 

— capacity   41,  60 

— cottages    19,  58 

— Infirmary  and  hospital 59,  60 

— nursery  for  infants 42 

— recreation  grounds  60 

Patients,  dispensary, 

— open  air  school 28 

— report    31 

Patients,  ex-,  open  air  quarters. 42,  72 

Patients,  Infirmary, 

— contagious    disease    42,52,53 

—  division    of    19,  50 

— examinations 40 

— food  distribution  and  dining  hall  46 
— quarters  and  recreation 

porches    52,  53 

— surgical   dressing  room 41 

Pharmacy    28,  38,  45,  51 ,61 

Physicians — dispensary    31,  92 

Plans, 

— arrangement,  medical   42 

— layout  of  buildings 21 

—preparation    of    14, 17 

—segregation    of    sexes 18,  21,  39 

Porches,  open  air, 

— children's  cottages   59 

— employes    48,  65 

— ex-patients    42 

— Infirmary    52,  53 

— Nurses'    Home    62,  63 

—Patients'  Cottages  55 

Power  house    22,  63 

Provisions, 

— contagious  diseases   42 

— incipient     and     moderately     ad- 
vanced      37 

— for  tuberculous  children 41 

— South  Side  Central  Dispensary..  28 

Quarters    and    grounds,    ambulant 
patients    53 

Receipts,  by  years 82 

Receiving    rooms 45,  48,  51,  65 

Reception   room,  nurses' 63 


CHICAGO  MUNICIPAL  TUBERCULOSIS  SANITARIUM 


INDEX— Cont'd 


Page 
Recreation, 

— grounds    39,  60,  63 

— porches    52,  53 

— room,  service  employes 48 

Refrigeration   plant 48,  65 

Registration  statistics 87 

Relief,  Bureau  of 32 

School   room,    open   air 28,41,59 

Service  Building, 

— description   and   location 22,  45 

Serving  pantry,  Infirmary 52,  53 

Sewerage     20 

Sitting  room  (see  Living  Room) 

Site,  purchase   of 15,  70 

South   Side   Central   Dispensary. 28,  29 
Sputum, 

— examinations    40,  87 

— incinerator    room 61 

— Infirmary  room 51 

Statistics,  Tuberculosis, 

— provisions 68,  71,  90 

Steward's  office,  location 48 

Stock  Yards  Dispensary 27 

Storage   rooms,    28,  45,  48,  64 

Sun  rooms,  location 52,  53 

Supervision  of  cases, 

— ambulant  cases    . .. 60 

— children    59 

— dispensary     25 

— medical     39 

Superintendent's  quarters    23 

Supply  rooms    45,  48 

Surgical, 

— department    41 

— room   28,  38,  45,  51 

Terrace,  children's  cottages 59 

Throat    and    nose    (see    Nose    and 
Throat) 


Page 

Toilet   (see   Bath   and   Toilet,   also 
Comfort  Stations) 

Tower 64 

Transformer  room, 

— Administration   Building    45 

— Infirmary 51 

Transformer  station    66 

Treatment, 

— dental  conditions    41 

— medical   arrangement    43 

— nose  and  throat 40 

— special    routine    60 

Tuberculosis  exhibit   34 

Tuberculosis   Sanitarium   Fund..  12,  70 
Tunnel    66 

Unit    Administration    Building.  .38,  60 
Utility  rooms, 

— men's  and  women's  infirmary. 52,  53 
— Nurses'  Home   61 

Vegetable    room 48 

Ventilation  (see  Windows) 

Ventilators    56,  60 

Visitors'  room   45 

Waiting  rooms    28,  45,  61 

Walks  and  drives 22,  55,  67 

Wash  bowls   50,  57,  58,  59 

Wash  room,  laundry 65 

Water    supply    20,  65 

Windows   

42,  45,  46,  48,  49,  56,  57,  60,  63,  64 


X-Ray, 

— rooms   

— study  of  cases 


.  ..28,  38,40,  45,57 
.   40 


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